Burke Gordon M, Wang Na, Blease Sue, Levy Daniel, Magnani Jared W
Department of Medicine, Boston University Medical Center, Boston, MA, USA.
Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA.
J Electrocardiol. 2014 May-Jun;47(3):288-93. doi: 10.1016/j.jelectrocard.2014.01.004. Epub 2014 Jan 6.
Digitized electrocardiography permits the rapid, automated quantification of electrocardiograms (ECGs) for analysis. Community- and population-based studies have increasingly integrated such data. Assessing the reproducibility of automated ECG measures with manual measures is a critical step in preparation for using automated measures for research purposes. We recently established an ECG repository of digitally recorded ECGs for the Framingham Heart Study and we sought to assess the reproducibility of automated and manual measures.
We selected 185 digitally recorded ECGs from routine visits of Framingham Heart Study participants spanning from 1986 to 2012. We selected the following ECG measures for their relevance to clinical and epidemiologic research: P wave duration, P wave amplitude, and PR interval in lead II; QRS duration and R wave amplitude in lead V6; and QT interval in lead V5. We obtained automated values for each waveform, and used a digital caliper for manual measurements. Digital caliper measurements were repeated in a subset (n=81) of the samples for intrarater assessment.
We calculated the intraclass correlation coefficient (ICC) values for the interrater and intrarater assessments. P wave duration had the lowest interrater ICC (r=0.46) and lowest intrarater ICC (r=0.57). R wave amplitude had the highest interrater and intrarater ICC (r=0.98) indicating excellent reproducibility. The remaining measures had interrater and intrarater ICCs of r≥0.81.
The interrater reproducibility findings for P wave amplitude, PR interval, QT interval, QRS duration, and R wave amplitude were excellent. In contrast, the reproducibility of P wave duration was more modest. These findings indicate high reproducibility of most automated and manual ECG measurements.
数字化心电图可实现心电图（ECG）的快速、自动量化分析。基于社区和人群的研究越来越多地整合了此类数据。评估自动心电图测量与手动测量的可重复性是准备将自动测量用于研究目的的关键步骤。我们最近为弗雷明汉心脏研究建立了一个数字记录心电图的ECG库，并试图评估自动和手动测量的可重复性。
我们从1986年至2012年弗雷明汉心脏研究参与者的常规就诊中选取了185份数字记录的心电图。我们选取了以下与临床和流行病学研究相关的ECG测量指标：II导联的P波时限、P波振幅和PR间期；V6导联的QRS时限和R波振幅；以及V5导联的QT间期。我们获取了每个波形的自动测量值，并使用数字卡尺进行手动测量。在一部分样本（n = 81）中重复进行数字卡尺测量以进行测量者内部评估。
我们计算了测量者间和测量者内评估的组内相关系数（ICC）值。P波时限的测量者间ICC最低（r = 0.46），测量者内ICC也最低（r = 0.57）。R波振幅的测量者间和测量者内ICC最高（r = 0.98），表明具有出色的可重复性。其余测量指标的测量者间和测量者内ICC均r≥0.81。
P波振幅、PR间期、QT间期、QRS时限和R波振幅的测量者间可重复性结果非常好。相比之下，P波时限的可重复性则较为一般。这些结果表明大多数自动和手动ECG测量具有较高的可重复性。
