The impact of an ECG computer analysis program on the cardiologist's interpretation. A cooperative study

Milliken, John A.; Pipberger, Hubert V.; Araoye, Mathew A.; Ari, Recep; Burggraf, Gary W.; Fletcher, Ross D.; Katz, Richard J.; Lopez, Emigdio A.; McCans, John; Silver, Albert M.

doi:10.1016/s0022-0736(83)80018-1

Cited by 15 publications

(8 citation statements)

References 10 publications

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“…These were finally interpreted by the cardiologists as atrial fibrillation (AF) in 5 cases, AF with premature ventricular contractions (PVCs) [4], normal sinus rhythm [4], atrial flutter [2], normal sinus rhythm with complete AV block and ventricular escape [2], and also AF with electronic ventricular pacemaker and PVCs, atrial flutter with PVCs, junctional rhythm with PVCs, normal sinus rhythm with first degree AV block, normal sinus rhythm with electronic ventricular pacemaker tracking P waves, and sequential AV pacing, one case of each.…”

Section: Resultsmentioning

confidence: 99%

Common errors in computer electrocardiogram interpretation

Guglin

Thatai

2006

International Journal of Cardiology

106

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Section: Resultsmentioning

confidence: 99%

Common errors in computer electrocardiogram interpretation

Guglin

Thatai

2006

International Journal of Cardiology

106

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“…Validation of the software for this system has been supplied by several studies where diagnostic accuracy has been tested using independent evidence of patients' diagnoses (Brohet and Richman, 1979;Milliken et al, 1983;Pipberger el al., 1975). In one clinical trial (Pipberger er al., 1975) computer analyses of more than 1 192 orthogonal ECG records were compared with the "true" diagnoses of the patients, based exclusively on objective, independent information according to clinical protocols.…”

Section: Resultsmentioning

confidence: 99%

“…In a more recent study Milliken and co-workers (Milliken et al, 1983) evaluated the VA computer analysis program and its impact on the cardiologist's interpretation in a cooperative study. Again, the program was evaluated against ECG-independent evidence of 180 patients' true diagnoses.…”

Section: Resultsmentioning

confidence: 99%

“…Evaluations where these recommendations have not been used are of limited value because of bias introduced by observers or evaluators (Pipberger and Cornfield, 1973). While this recommendation has not been followed for evaluation of other systems, the diagnostic performance of the Veterans Administration program has been extensively tested against independent evidence for the diagnoses and found to be quite satisfactory and reliable (Brohet and Richman, 1979;Milliken et al, 1983;Pipberger et al, 1975). It is fortunate that these evaluations against independent evidence do exist.…”

Section: Discussionmentioning

confidence: 99%

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A new microcomputer‐based ecg analysis system

Kyle

Klingeman

Conrad

et al. 1983

Clinical Cardiology

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Summary:A new automated ECG system using advances in microprocessor technology and computerized electrocardiography is described. This microcomputer-based system is self-contained and mobile. It acquires both the 12-lead and orthogonal lead (Frank) electrocardiograms and analyzes the latter within minutes. Software includes the program developed in the Veterans Administration which uses advanced statistical classification techniques and a large well-documented patient data base. Diagnostic probabilities are computed using a Bayesian approach. Diagnostic performance has been tested using independent clinical criteria and found to be quite accurate. This system enables the clinician to immediately review the computer's identifications, measurements, and diagnostic classifications and quickly * The ECG system was conceived by Jack Klingeman, who since 1965, has specialized in diagnostic techniques for noninvasive evaluation of cardiovascular disease. In cooperation with the other authors he implemented the system and began demonstrating its usefulness to the medical community. He completed the initial manuscript describing the system shortly before his death on July 27, 1982. use these results in clinical decision making. Serial comparisons are readily made since all previous recordings are stored on floppy diskettes. The use of microprocessors in this system makes it economically feasible for practicing physicians.

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“…and the Cornell index) by two doctors who were unaware of the aim and design of the study. As suggested by Millikcn et al [9], their diagnosis was accepted when in agreement; in cases of contradictory diagnoses a third cardiologist was consulted.…”

Section: Electrocardiogrammentioning

confidence: 99%

Left-Ventricular Hypertrophy in the Elderly: Unreliability of ECG Criteria in 477 Subjects Aged 65 Years or More

et al. 1996

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Aim: To evaluate the diagnostic reliability of the ECG diagnosis of left-ventricular hypertrophy (LVH) in a cohort of elderly subjects taken from a general population. Patients: The 447 subjects with perfect echocardiography and ECG results of the 2,254 included in the Cardiovascular Study in the Elderly. Methods: Sensitivity, specificity, positive and negative predictive value of the most commonly used ECG tests of LVH were calculated versus the gold standard, echocardiography. Results: All ECG tests had a very low sensitivity. Furthermore, except for the Cornell index and (at least in the normotensives) the Minnesota code, they were not able to demonstrate the higher prevalence of LVH in elderly females in comparison to males. The predictive value of ECG was constantly higher in males than females when negative; when positive, some tests were more predictive in males, some in females, and in others, equally predictive in both sexes. Conclusions: ECG is not a reliable method for screening LVH in elderly populations. Echocardiography and ECG give different information, and their reliability may be different if positive or negative.

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The impact of an ECG computer analysis program on the cardiologist's interpretation. A cooperative study

Cited by 15 publications

References 10 publications

Common errors in computer electrocardiogram interpretation

Common errors in computer electrocardiogram interpretation

A new microcomputer‐based ecg analysis system

Left-Ventricular Hypertrophy in the Elderly: Unreliability of ECG Criteria in 477 Subjects Aged 65 Years or More

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