ECGAssess: A Python-Based Toolbox to Assess ECG Lead Signal Quality

Electrocardiography (ECG) is the method most often used to diagnose cardiovascular diseases. To obtain a high-quality recording, the person conducting an ECG must be a trained expert. When these experts are not available, this important diagnostic tool cannot be used, consequently impacting the quality of healthcare. To avoid this problem, it must be possible for untrained healthcare professionals to record diagnostically useful ECGs so they can send the recordings to experts for diagnosis. The ECGAssess Python-based toolbox developed in this study provides feedback regarding whether ECG signals are of adequate quality. Each lead of the 12-lead recordings was classified as acceptable or unacceptable. This feedback allows people to identify and correct errors in the use of the ECG device. The toolbox classifies the signals according to stationary, heart rate, and signal-to-noise ratio. If the limits of these three criteria are exceeded, this is indicated to the user. To develop and optimize the toolbox, two annotators reviewed a data set of 1,200 ECG leads to assess their quality, and each lead was classified as acceptable or unacceptable. The evaluation of the toolbox was done with a new data set of 4,200 leads, which were annotated the same way. This evaluation shows that the ECGAssess toolbox correctly classified over 94% of the 4,200 ECG leads as either acceptable or unacceptable in comparison to the annotations.