通过计算机心电图分析对心脏病学家解释的心脏动的诊断准确性
José Escabí-Mendoza1, Norwin Rivera-Guzmán1, Jaime Rivera-Babilonia1
1Department of Cardiology, VA Caribbean Healthcare System, San Juan, PR, USA.
Journal of electrocardiology
|October 31, 2025
概括
对于心房动 (AF) 的自动心电图 (ECG) 解释有显著的诊断错误. 心脏病专家过度阅读提高了准确性,减少了错误分类和因延迟或不适当治疗而导致的潜在患者伤害.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 人工智能在医学中的应用
背景情况:
- 计算机化心电图 (ECG) 解释提供了效率提升,但在心房动 (AF) 的诊断准确性方面面临挑战.
- 在心电图上错误分类AF可能会导致由于不适当的治疗策略导致患者不良后果.
研究的目的:
- 为了比较自动ECG解释的诊断准确性与心脏病学家过度阅读检测AF.
- 评估AF识别诊断错误的临床影响和后果.
主要方法:
- 对5000个心电图进行了回顾性分析,并通过自动化软件进行了初步解释.
- 一个ECG的子集经过心脏病学家的阅读,而所有5000个都被两个心脏病学家以盲目的方式独立审查.
- 诊断指标进行了比较,并使用后勤回归识别了错误分类的预测因素.
主要成果:
- 在30%的病例中,自动解释错误地分类了AF (11%的假阳性,19%的假阴性).
- 心脏病学家的解释显示出更高的准确性 (灵敏度为87%与78%,特异性为99%与97%).
- 在41%的病例中,自动解释中的错误未被识别,导致抗凝血延迟,不适当的治疗和不良事件.
结论:
- 对AF的计算机化心电图解释容易导致严重的诊断错误.
- 心脏病学家过度阅读大大提高了AF检测的诊断准确性.
- 结构化的心脏病学家审查对于减轻与自动ECG误解相关的伤害至关重要.
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