Timmis G C, Bakalyar D M, Gordon S
J Am Coll Cardiol. 1986 Aug;8(2):301-9. doi: 10.1016/s0735-1097(86)80044-4.
The Hewlett-Packard 1000 electrocardiographic management system employs a user-interactive computer with revisable software. The diagnostic accuracy of this system in predicting left ventricular hypertrophy has been evaluated by comparing computer-predicted with anatomic left ventricular hypertrophy. The latter was defined as a left ventricular mass greater than 247 g as determined by M-mode echocardiography within 1 week of the computerized electrocardiogram. In this study, the Hewlett-Packard system was evaluated in 134 consecutive patients having anatomic left ventricular hypertrophy and 157 similarly studied patients with a normal left ventricular mass. By means of various combinations of voltage criteria, ST-T wave changes, abnormal QRS duration or ventricular activation time, left atrial enlargement and left axis deviation, the computer correctly identified 43 of 134 patients with left ventricular hypertrophy (sensitivity 32%); left ventricular hypertrophy was suggested or identified in an additional 18 patients with a normal left ventricular mass (specificity 89%). Graded probability statements (that is, the "strength" of the left ventricular hypertrophy diagnosis) increased with ventricular mass not only in patients with anatomic left ventricular hypertrophy but also in the patients with a "false positive" computerized electrocardiogram. Overall diagnostic accuracy was improved only in men by adjusting the definition of left ventricular hypertrophy for sex (at least 300 g for men and 220 g for women). Diagnostic accuracy was significantly better in patients 65 years of age and younger than in older patients (p = 0.007). It is concluded that the overall performance of this computer program (version ECLSB6) requires modification to improve its accuracy in identifying left ventricular hypertrophy.
惠普1000心电图管理系统采用了用户交互式计算机和可修订软件。通过将计算机预测结果与解剖学上的左心室肥厚进行比较，评估了该系统在预测左心室肥厚方面的诊断准确性。后者被定义为在计算机化心电图检查后1周内，通过M型超声心动图测定的左心室质量大于247克。在本研究中，对134例连续患有解剖学左心室肥厚的患者和157例左心室质量正常的类似研究患者进行了惠普系统评估。通过电压标准、ST-T波改变、异常QRS时限或心室激动时间、左心房增大和电轴左偏的各种组合，计算机正确识别出134例左心室肥厚患者中的43例（敏感性32%）；在另外18例左心室质量正常的患者中提示或识别出左心室肥厚（特异性89%）。分级概率陈述（即左心室肥厚诊断的“强度”）不仅在解剖学左心室肥厚的患者中，而且在计算机化心电图“假阳性”的患者中，都随着心室质量的增加而增加。通过根据性别调整左心室肥厚的定义（男性至少300克，女性至少220克），仅在男性中提高了总体诊断准确性。65岁及以下患者的诊断准确性明显优于老年患者（p = 0.007）。结论是，该计算机程序（版本ECLSB6）的总体性能需要改进，以提高其识别左心室肥厚的准确性。
