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Related Experiment Videos

Computer versus manual measurement of ST-segment deviation

M M Pelter1, M G Adams, B J Drew

  • 1University of California, School of Nursing, San Francisco 94143, USA.

Journal of Electrocardiology
|January 1, 1996
PubMed
Summary

Computerized electrocardiogram (ECG) analysis offers higher precision in measuring ST deviation than manual methods, potentially detecting ischemia missed by human interpretation. However, manual and computer ST scores should not be combined in research.

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Area of Science:

  • Cardiology
  • Medical Technology
  • Biomedical Engineering

Background:

  • Total ST scores from electrocardiograms (ECGs) estimate ischemic burden and predict reperfusion.
  • Computerized systems measure ST deviation to 10 microV, exceeding human resolution.
  • Manual ST score measurement has limitations in precision compared to automated analysis.

Purpose of the Study:

  • To compare computer-derived versus manually obtained ST scores in 12-lead ECGs during ischemia.
  • To assess the interrater reliability of manual ST measurements between two expert reviewers.

Main Methods:

  • 58 subjects with ST deviation (≥100 microV) during percutaneous transluminal coronary angioplasty (PTCA) were analyzed.
  • ST measurements were taken at J + 80 ms, summed across 12 leads.

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  • Two blinded reviewers manually measured ST deviation (≥50 microV); computer scores were compared.

    • Main Results:

    • High correlation found between manual and computer ST scores (r = .96).
    • Excellent interrater reliability was observed between the two manual reviewers (r = .96).
    • Computer measurements were consistently higher, likely due to human rounding down.

    Conclusions:

    • Manual ST deviation measurements can achieve high interrater reliability.
    • Computers may identify ischemia missed by manual analysis due to superior precision.
    • Mixing manual and computer ST deviation data in research is not recommended.