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[Comparison of 3 ECG computer programs with interpretation by physicians].

H Saner, A Lindeland, R Scallen

    Schweizerische Medizinische Wochenschrift
    |July 7, 1987
    PubMed
    Summary

    Three electrocardiogram (ECG) computer programs were evaluated for accuracy. The Marquette 12 SL (MAC) program showed the highest agreement with expert interpretation, demonstrating their utility for clinicians.

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    Area of Science:

    • Cardiology
    • Medical Informatics
    • Diagnostic Technology

    Background:

    • Electrocardiograms (ECGs) are crucial for diagnosing cardiac conditions.
    • Computerized ECG interpretation offers potential for efficiency and consistency.
    • Evaluating the diagnostic accuracy of different ECG computer programs is essential.

    Purpose of the Study:

    • To compare the accuracy of three ECG computer programs: Hewlett Packard (HP), Telemed (T), and Marquette 12 SL (MAC).
    • To assess the agreement between computer interpretations and expert human readers.
    • To identify specific diagnostic challenges for automated ECG analysis.

    Main Methods:

    • 140 ECGs from patients with diverse clinical abnormalities were analyzed.
    • Three computer programs (HP, T, MAC) and four experienced human interpreters evaluated the ECGs.

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  • Disagreements were categorized as major (affecting patient management) or minor, with consensus reached by a senior interpreter.

    • Main Results:

    • All computer programs correctly identified normal ECGs (100% sensitivity).
    • Major agreement percentages with consensus were: HP 79%, T 90%, and MAC 93%.
    • Computers struggled with rhythm disturbances, myocardial infarction, T-wave changes, and ventricular hypertrophy; human readers missed conditions like AV block and QT prolongation.

    Conclusions:

    • Significant accuracy differences exist between the evaluated ECG computer programs.
    • All three systems demonstrate sufficient accuracy for clinical utility.
    • Physician over-reading of all ECGs is recommended, especially for critical clinical decisions.