Software for computerised analysis of cardiotocographic traces
Software for computerised analysis of cardiotocographic traces
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DOI：
10.1016/j.cmpb.2015.10.008
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发表时间：
2016-02-01
影响因子：
6.1
通讯作者：
Cesarelli, M.
中科院分区：
文献类型：
--
作者：
Romano, M.;Bifulco, P.;Cesarelli, M.
尽管心电监护在胎儿监护中得到了广泛应用，但胎儿状况的评估存在相当大的观察者间和观察者内的变异性。为了克服目测心电监护评估的主要局限性，最近开发了分析心电监护记录的计算机化方法。在本研究中，提出了一种新的胎儿心率自动分析软件。它允许自动测量最相关的参数，这些参数可以从心电图示踪迹中得出。对模拟和真实的心电描记轨迹进行分析，以检验软件的可靠性。在人工轨迹中，我们模拟了一组要识别的事件(加速、减速和收缩)。取而代之的是，在真实信号的情况下，将计算机化的分析结果与18名专家临床医生进行的视觉评估进行比较，并计算三个性能指数，以获得关于所提议的软件的性能的信息。该软件显示了我们认为令人满意的初步性能，因为结果完全符合要求，对人工信号的测试证明了这一点，其中所有模拟事件都是从软件中检测出来的。相反，与产科医生的评价相比，计算的绩效指数并不令人满意；事实上，它们导致统计参数的值如下：敏感度为93%，阳性预测值为82%，准确率为77%。这很可能是由临床医生进行的痕迹注释的高度可变性引起的。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Despite the widespread use of cardiotocography in foetal monitoring, the evaluation of foetal status suffers from a considerable inter and intra-observer variability In order to overcome the main limitations of visual cardiotocographic assessment, computerised methods to analyse cardiotocographic recordings have been recently developed. In this study, a new software for automated analysis of foetal heart rate is presented. It allows an automatic procedure for measuring the most relevant parameters derivable from cardiotocographic traces. Simulated and real cardiotocographic traces were analysed to test software reliability. In artificial traces, we simulated a set number of events (accelerations, decelerations and contractions) to be recognised. In the case of real signals, instead, results of the computerised analysis were compared with the visual assessment performed by 18 expert clinicians and three performance indexes were computed to gain information about performances of the proposed software. The software showed preliminary performance we judged satisfactory in that the results matched completely the requirements, as proved by tests on artificial signals in which all simulated events were detected from the software. Performance indexes computed in comparison with obstetricians' evaluations are, on the contrary, not so satisfactory; in fact they led to obtain the following values of the statistical parameters: sensitivity equal to 93%, positive predictive value equal to 82% and accuracy equal to 77%. Very probably this arises from the high variability of trace annotation carried out by clinicians. (C) 2015 Elsevier Ireland Ltd. All rights reserved.