[Automatic computerized ECG interpretation]

The introduction of computerised interpretation of an electrocardiogram depends on the reliability of the interpretation. Previous investigations of computerised ECG diagnosis have been concerned with the diagnostic significance of selected QRST morphology changes and/or arrhythmia. In the present investigation, a full interpretation of the recorded values has been performed in terms of diagnosis and conclusions for each ECG. The investigation included 1,000 ECG's from 500 in-patients, at a Central Hospital. The ECG's were recorded on Mingograf 740 from Siemens-Elema, AB. All data from each computerised ECG were compared with the results of an ordinary visual analysis. For the rhythm diagnosis, mistakes were found in 11% of the ECG's, and in 2-3% of the mistakes the wrong diagnosis was considered of clinical significance. For the diagnosis of the QRST morphology, mistakes were found in 29% of the electrocardiograms with considered clinical significance in 20% of the ECG's. Agreement between the diagnosis "normal ECG" in the computer-based ECG interpretation and the visual analysed ECG with the diagnosis "normal ECG", was found in 99.4%. In the diagnosis of cardiac rhythm, agreement was found in 89% of the ECG's, whereas agreement concerning the QRST morphology was 71%. The differences were mainly because of too narrow boundaries in the diagnosis of normal ECG's in the investigated computerprogram. It is concluded, that the value of automatically computerised interpretation of an electrocardiogram depends to a large extent on the criteria encoded in the computerprogram employed.