Instituto de Tecnologia, Universidade Federal do Pará, Belém, Brazil.
Instituto Alberto Luiz Coimbra de Pós Graduação e Pesquisa de Engenharia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Phys Eng Sci Med. 2021 Jun;44(2):473-485. doi: 10.1007/s13246-021-00996-2. Epub 2021 Apr 2.
The diffusion of telemedicine opens-up a new perspective for the development of technologies furthered by Biomedical Engineering. In particular, herein we deal with those related to telediagnosis through multiple-lead electrocardiographic signals. This study focuses on the proof-of-concept of an internet-based telemedicine system as a use case that attests to the feasibility for the development, within the university environment, of techniques for remote processing of biomedical signals for adjustable detection of myocardial ischemia episodes. At each signal lead, QRS complexes are detected and delimited with the J-point marking. The same procedure to detect the complex is used to identify the respective T wave, then the area over the ST segment is applied to detect ischemia-related elevations. The entire system is designed on web-based telemedicine services using multiuser, remote access technologies, and database. The measurements for sensitivity and precision had their respective averages calculated at 11.79 and 24.21% for the leads of lower noise. The evaluations regarding the aspects of user friendliness and the usefulness of the application, resulted in 88.57 and 89.28% of broad or total acceptance, respectively. They are robust enough to enable scalability and can be offered by cloud computing, besides enabling the development of new biomedical signal processing techniques within the concept of distance services, using a modular architecture with collaborative bias.
远程医疗的普及为生物医学工程推动的技术发展开辟了新的视角。特别是，本文主要研究了通过多导联心电图信号进行远程诊断的相关技术。本研究以基于互联网的远程医疗系统为例，证明了在大学环境中开发用于远程处理生物医学信号的技术的可行性，这些技术可用于检测心肌缺血事件的可调检测。在每个信号导联上，都会检测并标记 QRS 波群的起点。用于检测该复合波的相同过程也用于识别各自的 T 波，然后应用 ST 段上的面积来检测与缺血相关的升高。整个系统基于基于网络的远程医疗服务设计，使用多用户、远程访问技术和数据库。对于噪声较低的导联，灵敏度和精度的测量值的平均值分别为 11.79%和 24.21%。关于用户友好性和应用实用性的评估结果分别为广泛或完全接受的 88.57%和 89.28%。它们具有足够的健壮性，可以实现可扩展性，并可以通过云计算提供，同时还可以在远程服务的概念下使用协作式偏置的模块化架构来开发新的生物医学信号处理技术。
