{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:26:34Z","timestamp":1789453594767,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005321","name":"American College of Clinical Pharmacy Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>Methadone is associated with QT interval prolongation and torsades de pointes. Expert panel recommendations advocate a pre\u2010methadone electrocardiogram (ECG) and another ECG at 30 days of therapy in patients with risk factors. Some guidelines recommend a pre\u2010methadone ECG and routine ECG monitoring in all methadone patients, but this is controversial due to the resources required. Availability of a convenient, less resource\u2010intensive method of ECG monitoring for patients taking methadone is desirable. The objective of this study was to assess the accuracy of a handheld smartphone ECG (iECG) for QT measurement in patients on maintenance methadone therapy in an urban opioid treatment program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Urban opioid treatment program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p><jats:italic>n<\/jats:italic> = 115 patients in normal sinus rhythm who were on steady\u2010state maintenance methadone therapy<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Patients (<jats:italic>n<\/jats:italic> = 115) underwent a simultaneous 12\u2010lead ECG and a single\u2010lead iECG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The first three QT and RR intervals from lead II of the 12\u2010lead ECG and simulated lead I from the iECG were compared using the Bland\u2010Altman analysis of measurement agreement. Mean [\u00b1 standard deviation) age was 34 \u00b1 11 years; 71% were female, 75% were white. Compared to the 12\u2010lead ECG, the iECG was associated with a QTc bias of \u2010 0.14 ms (SD = 12 ms, 95% CI = \u20102.4 to 2.1 ms). The absolute mean difference in QTc between the two methods was 9.5 \u00b1 7.1 ms. For identification of patients with methadone\u2010associated QTc prolongation, the iECG performed moderately well [<jats:italic>c<\/jats:italic>\u2010statistic 0.97 (95% CI 0.91\u20130.99); sensitivity and specificity 75% (95% CI 43\u201395%) and 99% (95% CI 94\u201399%), respectively]. The positive and negative likelihood ratios of the iECG for identifying patients with methadone\u2010associated QTc prolongation were 77.25 (95% CI 10.69 to 558.18) and 0.25 (95% CI 0.09 to 0.67), respectively, while the positive and negative predictive values were 90% (95% CI 56\u201399%) and 97% (95% CI 92\u201399%), respectively. The accuracy of the iECG for identifying patients with QTc prolongation was 97% (95% CI 91\u201399%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A handheld smartphone ECG is accurate for QT interval measurement in patients taking maintenance methadone therapy, and its performance is moderately good for identifying patients with methadone\u2010associated QTc prolongation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2521","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T07:41:20Z","timestamp":1616830880000},"page":"494-500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Accuracy of a single\u2010lead mobile smartphone electrocardiogram for QT interval measurement in patients undergoing maintenance methadone therapy"],"prefix":"10.1002","volume":"41","author":[{"given":"Erika 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