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The Diagnostic Performance of Computer Programs for the Interpretation of Electrocardiograms

The Diagnostic Performance of Computer Programs for the Interpretation of Electrocardiograms AbstractBackground.Computer programs for the interpretation of electrocardiograms (ECGs) are now widely used. However, a systematic assessment of various computer programs for the interpretation of ECGs has not been performed.Methods.We undertook a large international study to compare the performance of nine electrocardiographic computer programs with that of eight cardiologists in interpreting ECGs in 1220 clinically validated cases of various cardiac disorders. ECGs from the following groups were included in the sample: control patients (n = 382); patients with left ventricular hypertrophy (n = 183), right ventricular hypertrophy (n = 55), or biventricular hypertrophy (n = 53); patients with anterior myocardial infarction (n = 170), inferior myocardial infarction (n = 273), or combined myocardial infarction (n = 73); and patients with combined infarction and hypertrophy (n = 31). The interpretations of the computer programs and the cardiologists were compared with the clinical diagnoses made independently of the ECGs, and the computer interpretations were compared with those of the cardiologists.Results.The percentage of ECGs correctly classified by the computer programs (median, 91.3 percent) was lower than that for the cardiologists (median, 96.0 percent; P<0.01). The median sensitivity of the computer programs was also significantly lower than that of the cardiologists in diagnosing left ventricular hypertrophy (56.6 percent vs. 63.9 percent, P<0.02), right ventricular hypertrophy (31.8 percent vs. 46.6 percent, P<0.01), anterior myocardial infarction (77.1 percent vs. 84.9 percent, P<0.001), and inferior myocardial infarction (58.8 percent vs. 71.7 percent, P<0.0001). The median total accuracy level (the percentage of correct classifications) was 6.6 percent lower for the computer programs (69.7 percent) than for the cardiologists (76.3 percent; P<0.001). However, the performance of the best programs nearly matched that of the most accurate cardiologists.Conclusions.Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders. (N Engl J Med 1991;325: 1767–73.) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The New England Journal of Medicine The New England Journal of Medicine

The Diagnostic Performance of Computer Programs for the Interpretation of Electrocardiograms

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References (24)

Publisher
The New England Journal of Medicine
ISSN
0028-4793
eISSN
1533-4406
DOI
10.1056/NEJM199112193252503
pmid
1834940
Publisher site
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Abstract

AbstractBackground.Computer programs for the interpretation of electrocardiograms (ECGs) are now widely used. However, a systematic assessment of various computer programs for the interpretation of ECGs has not been performed.Methods.We undertook a large international study to compare the performance of nine electrocardiographic computer programs with that of eight cardiologists in interpreting ECGs in 1220 clinically validated cases of various cardiac disorders. ECGs from the following groups were included in the sample: control patients (n = 382); patients with left ventricular hypertrophy (n = 183), right ventricular hypertrophy (n = 55), or biventricular hypertrophy (n = 53); patients with anterior myocardial infarction (n = 170), inferior myocardial infarction (n = 273), or combined myocardial infarction (n = 73); and patients with combined infarction and hypertrophy (n = 31). The interpretations of the computer programs and the cardiologists were compared with the clinical diagnoses made independently of the ECGs, and the computer interpretations were compared with those of the cardiologists.Results.The percentage of ECGs correctly classified by the computer programs (median, 91.3 percent) was lower than that for the cardiologists (median, 96.0 percent; P<0.01). The median sensitivity of the computer programs was also significantly lower than that of the cardiologists in diagnosing left ventricular hypertrophy (56.6 percent vs. 63.9 percent, P<0.02), right ventricular hypertrophy (31.8 percent vs. 46.6 percent, P<0.01), anterior myocardial infarction (77.1 percent vs. 84.9 percent, P<0.001), and inferior myocardial infarction (58.8 percent vs. 71.7 percent, P<0.0001). The median total accuracy level (the percentage of correct classifications) was 6.6 percent lower for the computer programs (69.7 percent) than for the cardiologists (76.3 percent; P<0.001). However, the performance of the best programs nearly matched that of the most accurate cardiologists.Conclusions.Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders. (N Engl J Med 1991;325: 1767–73.)

Journal

The New England Journal of Medicine – The New England Journal of Medicine

Published: Dec 19, 1991

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