Evaluating the Impact of Pseudo-Colour and Coordinate System on the Detection of Medication-induced ECG Changes

Alahmadi, Alaa; Davies, Alan; Royle, Jennifer; Vigo, Markel; Jay, Caroline

doi:10.1145/3290605.3300353

Cited by 7 publications

(5 citation statements)

References 57 publications

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“…In this paper, we investigate whether a pseudo-colouring technique can reliably show prolongation of the QT-interval on an ECG, such that it be identified by a lay person. In an earlier feasibility study, we found that superimposing pseudo-colouring on the ECG using a spectrum-approximation colour sequence significantly improved people's ability to detect increases in the QT-interval at a low normal heart rate, when compared with a reference ECG stimulus showing a normal QT baseline [51]. This initial investigation had several limitations that affected the generalisability of the results.…”

Section: Plos Onementioning

confidence: 96%

“…Coordinate system. Our previous work indicates that people may be able to detect QTprolongation more accurately on a Polar coordinate system [51]. To see whether this held when ECGs with varying heart rates are presented in isolation, we compared two coordinate systems (Cartesian and Polar) with and without pseudo-colouring.…”

Section: Plos Onementioning

confidence: 99%

“…From a perceptual-cognitive perspective, this may be related to the fact that people are poor at perceiving quantity represented along a horizontal scale [47][48][49]. Research has also shown that changes in the T-wave morphology and/or artifacts in the ECG signal can cause misinterpretation of the QT-interval length [40,41,50,51]. The effect of heart rate on the QT-interval is another challenge, as it is the proportionate rather than absolute length that is important, and it is common to misinterpret the QT-interval at heart rates that differ from the 'standard' 60 bpm [52].…”

Section: Plos Onementioning

confidence: 99%

“…To apply the pseudo-colouring accurately for different heart rates, it was necessary to identify the value of QT-prolongation that determines being 'at risk' for TdP. In the previous study [51], where all ECGs had a 60 bpm heart rate, we used the half R-R interval rule to identify at risk QT-prolongation. This states that the QT-interval is prolonged if it is equal to or longer than the half R-R interval (midpoint between two consecutive R-peaks) [52,71].…”

Section: Visualisation Designmentioning

confidence: 99%

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Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate

et al. 2020

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Drug-induced long QT syndrome (diLQTS), characterized by a prolongation of the QT-interval on the electrocardiogram (ECG), is a serious adverse drug reaction that can cause the life-threatening arrhythmia Torsade de Points (TdP). Self-monitoring for diLQTS could therefore save lives, but detecting it on the ECG is difficult, particularly at high and low heart rates. In this paper, we evaluate whether using a pseudo-colouring visualisation technique and changing the coordinate system (Cartesian vs. Polar) can support lay people in identifying QT-prolongation at varying heart rates. Four visualisation techniques were evaluated using a counterbalanced repeated measures design including Cartesian no-colouring, Cartesian pseudo-colouring, Polar no-colouring and Polar pseudo-colouring. We used a multireader, multi-case (MRMC) receiver operating characteristic (ROC) study design within a psychophysical paradigm, along with eye-tracking technology. Forty-three lay participants read forty ECGs (TdP risk n = 20, no risk n = 20), classifying each QT-interval as normal/ abnormal, and rating their confidence on a 6-point scale. The results show that introducing pseudo-colouring to the ECG significantly increased accurate detection of QT-interval prolongation regardless of heart rate, T-wave morphology and coordinate system. Pseudocolour also helped to reduce reaction times and increased satisfaction when reading the ECGs. Eye movement analysis indicated that pseudo-colour helped to focus visual attention on the areas of the ECG crucial to detecting QT-prolongation. The study indicates that pseudo-colouring enables lay people to visually identify drug-induced QT-prolongation regardless of heart rate, with implications for the more rapid identification and management of diLQTS.

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Section: Plos Onementioning

confidence: 96%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Section: Visualisation Designmentioning

confidence: 99%

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Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate

et al. 2020

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“…Figure 2 shows examples of ECGs with pseudo-colouring that have di erent heart rates, but similar levels of TdP risk according to QTinterval; the dashed lines represent the QT nomogram line value at risk of TdP for a given heart rate. More details about the pseudo-colouring technique and its evaluation can be found in [3,4].…”

Section: A Human-like Approach To Automated Ecg Interpretationmentioning

confidence: 99%

An explainable algorithm for detecting drug-induced QT-prolongation at risk of torsades de pointes (TdP) regardless of heart rate and T-wave morphology

Alahmadi

Davies

Royle³

et al. 2021

Computers in Biology and Medicine

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A Blueprint for an AI & AR-Based Eye Tracking System to Train Cardiology Professionals Better Interpret Electrocardiograms

Sqalli

Al-Thani

El‐Shazly

et al. 2022

Persuasive Technology

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Evaluating the Impact of Pseudo-Colour and Coordinate System on the Detection of Medication-induced ECG Changes

Cited by 7 publications

References 57 publications

Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate

Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate

An explainable algorithm for detecting drug-induced QT-prolongation at risk of torsades de pointes (TdP) regardless of heart rate and T-wave morphology

A Blueprint for an AI & AR-Based Eye Tracking System to Train Cardiology Professionals Better Interpret Electrocardiograms

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