Assessment of the performance of electrocardiographic computer programs with the use of a reference data base.

Abstract

To allow an exchange of measurements and criteria between different electrocardiographic (ECG) computer programs, an international cooperative project has been initiated aimed at standardization of computer-derived ECG measurements. To this end an ECG reference library of 250 ECGs with selected abnormalities was established and a comprehensive reviewing scheme was devised for the visual determination of the onsets and offsets of P, QRS, and T waves. This task was performed by a group of cardiologists on highly amplified, selected complexes from the library of ECGs. With use of a modified Delphi approach, individual outlying point estimates were eliminated in four successive rounds. In this way final referee estimates were obtained that proved to be highly reproducible and precise. This reference data base was used to study measurement results obtained with nine vectorcardiographic and 10 standard 12-lead ECG analysis programs. The medians of program determinations of P, QRS, and T wave onsets and offsets were close to the final referee estimates. However, an important variability could be demonstrated between measurements from individual programs and mean differences from the referee estimates amounted to 10 msec for QRS for certain programs. In addition, the variances of all programs with respect to the referee point estimates were variable. Some programs proved to be more accurate and stable when the data from high-vs low-noise recordings were analyzed. Average Q wave durations calculated from ECGs for which programs agreed on the presence of a Q or QS wave differed by more than 8 msec in several program-to-program comparisons. Such differences may have important consequences with respect to diagnostic performance. Various factors that might explain these differences have been determined. The present study demonstrates that to allow an exchange of results and diagnostic criteria between different ECG computer programs, definitions, minimum wave requirements, and measurement procedures urgently need to be standardized.Circulation 71, No. 3, 523-534, 1985. DURING the last decade rapid growth has occurred in computer electrocardiographic (ECG) processing.1-3 At present, however, no standards for quantitative ECG analysis exist. There is a lack of agreement on The authors academic affiliations are listed in the Common Standards for Quantitative Electrocardiography (CSE) organizational structure that appears before the references.

Significance of initial ST segment elevation and depression for the management of thrombolytic therapy in acute myocardial infarction. European Cooperative Study Group for Recombinant Tissue-Type Plasminogen Activator.

“…The reproducibility for determining accurately the onset of QRS is far greater than that for determining the end of the T wave. 34 Clinical Implications The present study demonstrates that not only ST elevation but also reciprocal ST depression are useful for predicting the evolving infarct size at admission and for guiding management of thrombolytic therapy. Our findings demonstrate that the sum of initial ST elevation and of the contralateral ST depression reflect the extent of ischemic injury, in inferior and also anterior MI.…”

Qt Zaman Araliğinin Gauss Karişim Modeli̇ Ve Yapay Si̇ni̇r Aği Tabanli Tespi̇ti̇

“…Pozitif belirleyicilik değeri QRS ve T dalgasının sürekli çakışmasından dolayı çok düşük seviyelere ulaşmıştır. Ancak sunulan algoritmanın değerleri incelendiğinde ortalama hata ve standart sapma değerlerinin klinik uygulamalar için kabul edilebilir seviyede olduğu gözlemlenmiştir [10].…”

A Low-Complexity ECG Feature Extraction Algorithm for Mobile Healthcare Applications

“…As a result the previous knn rule could not be applied. For these signals we followed the CSE guidelines as described in [12]. In every record, the 12 leads were divided into 4 groups each containing the 3 simultaneously captured leads.…”