Assessment of the performance of electrocardiographic computer programs with the use of a reference data base.
Assessment of the performance of electrocardiographic computer programs with the use of a reference data base.
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使用参考数据库评估心电图计算机程序的性能。
作者：
J. L. Willems;P. Arnaud;H. Jan;Van;Bemmel;P. Bourdillon;C. Brohet;S. Volta;J. D. Andersen;R. Degani;B. Denis;Michel Demeester;J. Dudeck;F. M. Harms;P. Macfarlane;G. Mazzocca;J. Meyer;J. Michaelis;J. Pardaens;Bernard C. Reardon;Henk J. Ritsema;Eck;Etienne 0. Robles;De;Medina;P. Rubel;J. Talmon;C. Zywietz
为了允许在不同的心电图（ECG）计算机程序之间交换测量和标准，已经发起了一个国际合作项目，旨在使计算机导出的ECG测量标准化。为此，建立了一个包含250个选定异常ECG的ECG参考库，并设计了一个全面的审查方案，用于目视确定P波、QRS波和T波的起始和偏移。这项任务是由一组心脏病专家对心电图库中高度放大的选定复合波进行的。使用修改后的德尔菲法，在连续四轮中消除了个别离群点估计值。通过这种方式，获得了最终的裁判估计，证明是高度可重复和精确的。这个参考数据库被用来研究测量结果与9向量心电图和10个标准的12导联心电图分析程序。P波、QRS波和T波起始和偏移的程序测定中位数接近最终裁判估计值。然而，在个别程序的测量值之间可以证明一个重要的变异性，并且对于某些程序，QRS与裁判估计值的平均差异达10 msec。此外，所有程序相对于裁判点估计的方差是可变的。一些程序被证明是更准确和稳定的数据时，从高与低噪音录音进行了分析。根据ECG计算的平均Q波持续时间，在几个程序间比较中，程序同意存在Q波或QS波，差异超过8 msec。这些差异可能对诊断性能产生重要影响。可能解释这些差异的各种因素已经确定。目前的研究表明，允许不同的心电图计算机程序，定义，最小波的要求和测量程序之间的结果和诊断标准的交换迫切需要标准化。
To allow an exchange of measurements and criteria between different electrocardiographic (ECG) computer programs, an international cooperative project has been initiated aimed at standardization of computer-derived ECG measurements. To this end an ECG reference library of 250 ECGs with selected abnormalities was established and a comprehensive reviewing scheme was devised for the visual determination of the onsets and offsets of P, QRS, and T waves. This task was performed by a group of cardiologists on highly amplified, selected complexes from the library of ECGs. With use of a modified Delphi approach, individual outlying point estimates were eliminated in four successive rounds. In this way final referee estimates were obtained that proved to be highly reproducible and precise. This reference data base was used to study measurement results obtained with nine vectorcardiographic and 10 standard 12-lead ECG analysis programs. The medians of program determinations of P, QRS, and T wave onsets and offsets were close to the final referee estimates. However, an important variability could be demonstrated between measurements from individual programs and mean differences from the referee estimates amounted to 10 msec for QRS for certain programs. In addition, the variances of all programs with respect to the referee point estimates were variable. Some programs proved to be more accurate and stable when the data from high- vs low-noise recordings were analyzed. Average Q wave durations calculated from ECGs for which programs agreed on the presence of a Q or QS wave differed by more than 8 msec in several program-to-program comparisons. Such differences may have important consequences with respect to diagnostic performance. Various factors that might explain these differences have been determined. The present study demonstrates that to allow an exchange of results and diagnostic criteria between different ECG computer programs, definitions, minimum wave requirements, and measurement procedures urgently need to be standardized.