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三级医院中基于集体智慧的移动应用心电图会诊与传统系统心电图解读的比较

Comparison of Mobile Application-Based ECG Consultation by Collective Intelligence and ECG Interpretation by Conventional System in a Tertiary-Level Hospital.

作者信息

Hwang You Mi, Kim Ji Hyun, Kim Yoo Ri

机构信息

Department of Cardiology, St.Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.

Division of Cardiology, Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea.

出版信息

Korean Circ J. 2021 Apr;51(4):351-357. doi: 10.4070/kcj.2020.0364.

Abstract

BACKGROUND AND OBJECTIVES

A mobile application (app)-based electrocardiogram (ECG) consultation system (InterMD Co., Ltd., Seoul, Korea) using the collective intelligence (CI) and the availability of large-scale digitized ECG data would extend the utility of ECGs beyond their current limitations, while at the same time preserving interpretability that remains critical to medical decision-making.

METHODS

We developed a new mobile app-based ECG consultation system by CI for general practitioners. We compared the responses of ECG reading between the mobile app-based CI system and the conventional system in a tertiary referring hospital.

RESULTS

We analyzed 376 consecutive ECGs between December 2017 and May 2019. Of these, 159 ECGs (42.3%) were interpreted by CI through the mobile app-based ECG consultation system and 217 ECGs (57.7%) were analyzed by cardiologists in the conventional systems based on electronic medical record data in a tertiary hospital. All ECG readings were confirmed by an electrophysiologist (EP). The time to an initial response by the CI system was faster than that of the conventional system (6.6 hours vs. 35.8 hours, p<0.0001). The number of responses of each ECG in CI system outnumbered those of the conventional system in the tertiary hospital (3.1 vs. 1.2, p<0.0001). The consensus of the ECG readings with EP was similar in both systems (98.6% vs. 100%, p=0.158).

CONCLUSIONS

The mobile app-based ECG consultation system by CI is as reliable method as the conventional referral system. It would expand the app of the 12-lead ECG with the collaboration of physicians in clinics and hospitals without time and space constraints.

摘要

背景与目的

基于移动应用程序(app)的心电(ECG)会诊系统(韩国首尔InterMD有限公司)利用集体智能(CI)和大规模数字化ECG数据的可用性,将拓展ECG的效用,突破其当前局限,同时保持对医疗决策至关重要的可解释性。

方法

我们通过CI为全科医生开发了一种基于移动应用程序的新型ECG会诊系统。我们在一家三级转诊医院比较了基于移动应用程序的CI系统和传统系统对ECG解读的反应。

结果

我们分析了2017年12月至2019年5月期间连续的376份ECG。其中,159份ECG(42.3%)通过基于移动应用程序的ECG会诊系统由CI进行解读,217份ECG(57.7%)由三级医院的心脏病专家根据电子病历数据在传统系统中进行分析。所有ECG解读均由电生理学家(EP)确认。CI系统的初始反应时间比传统系统更快(6.6小时对35.8小时,p<0.0001)。CI系统中每份ECG的反应数量超过三级医院传统系统中的反应数量(3.1对1.2,p<0.0001)。两个系统中ECG解读与EP的一致性相似(98.6%对100%,p=0.158)。

结论

基于移动应用程序的CI ECG会诊系统与传统转诊系统一样可靠。它将在诊所和医院医生的协作下,不受时间和空间限制地扩展1导联ECG的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9cb/8022025/7263d4996c4d/kcj-51-351-g001.jpg

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