Kors J A, van Herpen G, Willems J L, van Bemmel J H
Department of Medical Informatics, Faculty of Medicine and Health Sciences, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1992 Jul 1;70(1):96-9. doi: 10.1016/0002-9149(92)91397-m.
In the international project "Common Standards for Quantitative Electrocardiography" (CSE), diagnostic results of different computer programs for the interpretation of the electrocardiogram (ECG) and of the vectorcardiogram (VCG) were combined, and it was shown that the "combined program" performs better than each program separately. Because the program MEANS (Modular ECG Analysis System) comprises 2 different classification programs--one for the ECG, the other for the VCG--this allowed investigation of whether the combined interpretations would yield a better diagnostic result than either one separately. This approach requires that a VCG always be recorded in addition to the ECG. To circumvent this complication, the VCG was reconstructed from the simultaneously recorded ECG leads. This reconstructed VCG was then interpreted by the VCG classification program, whereupon the diagnostic interpretations of the ECG and the reconstructed VCG were combined. For the validation, the CSE database of documented ECGs and VCGs (n = 1,220) was used. The combination of the ECG and VCG interpretations yielded a better diagnostic result than each interpretation program separately (total accuracy 74.2% (ECG + VCG) vs 69.8% (ECG) and 70.2% (VCG), p less than 0.001 in both cases). The results for the reconstructed VCG (total accuracy 70.5%) are comparable to those for the ECG and the VCG (p greater than 0.10 in both cases). The performance of the combined interpretations of ECG and reconstructed VCG (total accuracy 73.6%) is approximately the same as that of the combined ECG and VCG (p greater than 0.10). Thus, the performance of an ECG computer program can be improved by incorporating both ECG and VCG classificatory knowledge, using only the ECG itself.
在国际项目“定量心电图通用标准”（CSE）中，将不同计算机程序对心电图（ECG）和向量心电图（VCG）的诊断结果进行了合并，结果表明“合并程序”的表现优于各个单独的程序。由于MEANS程序（模块化心电图分析系统）包含2种不同的分类程序——一种用于ECG，另一种用于VCG——这使得可以研究合并解读是否会比单独使用任何一种程序产生更好的诊断结果。这种方法要求除了ECG之外还必须始终记录VCG。为了避免这种复杂性，从同时记录的ECG导联重建了VCG。然后由VCG分类程序对重建的VCG进行解读，随后将ECG和重建的VCG的诊断解读合并。为了进行验证，使用了记录有ECG和VCG的CSE数据库（n = 1,220）。ECG和VCG解读的合并产生了比各个单独解读程序更好的诊断结果（总准确率74.2%（ECG + VCG）对69.8%（ECG）和70.2%（VCG），两种情况p均小于0.001）。重建VCG的结果（总准确率70.5%）与ECG和VCG的结果相当（两种情况p均大于0.10）。ECG和重建VCG的合并解读的表现（总准确率73.6%）与ECG和VCG合并的表现大致相同（p大于0.10）。因此，仅使用ECG本身，通过纳入ECG和VCG分类知识，可以提高ECG计算机程序的性能。
