Fig 4

Two questions were deemed as “Appropriate” in round 1 but must be revised in round 2. A The success rate was high at 0.89, and the IQR was low at 1.0, indicating that round 1 was classified as “Appropriate.” However, multiple choices could not be excluded, thus requiring modification. Specifically, the AV block could not be excluded as an answer in addition to the contestant’s answer of supraventricular premature contractions. B It was deemed appropriate owing to the high median score and low IQR; however, the success rate was low at 0.44. Thus, the reason was verified in round 2. Although the authors had assumed that the answer was ventricular fibrillation, five of the nine experts had answered ventricular tachycardia. They all concurred that it was a clinically important question; however, because the choice could not be excluded, it was decided that a modification was needed, including the ECG imaging. ECG = electrocardiogram; IQR = interquartile range