Rodríguez Velásquez Javier O, Correa Herrera Sandra C, Bertolotto Cepeda Ana M
Insight Group, Hospital Universitario Nacional de Colombia, Bogotá, Colombia.
Unidad de Recién Nacidos, Hospital Universitario San Ignacio, Bogotá, Colombia.
Cardiol Young. 2023 Mar;33(3):415-419. doi: 10.1017/S104795112200097X. Epub 2022 May 6.
Based on probability theory, a methodology that allows diagnosing neonatal cardiac dynamics was previously developed; however, diagnostic applications of this method are required to validate it to the neonatal cardiac dynamics was conducted, allowing to differentiate normal from pathological dynamics. The hourly maximum and minimum heart rate values from 39 continuous and ambulatory electrocardiographic records with a minimum length of 21 hours were taken, from newborns between 0 and 10 days of life, 9 clinically within normality limits and 30 with cardiac pathologies. The probability of occurrence of heart rates in ranges of 5 beats/minute was calculated. The distributions of probability were analysed, and finally the diagnosis was determined by the physical-mathematical methodology. Then, a statistical validation of sensitivity, specificity, and diagnostic agreement was performed. Normal registries showed probability distributions with absent or minimal presence of heart rates of the ranges between 125 and 135 beats/minute, while the abnormal ones had values within these ranges, as well as absence or minimal presence of heart rates from 75 beats/minute to 85 beats/minute. The sensitivity and specificity were 100%, and the Kappa coefficient had a value of 1. Hereby, it is concluded that through an application of a physical-mathematical methodology of neonatal cardiac diagnosis, it is possible to differentiate normality from disease.
基于概率论，先前已开发出一种可诊断新生儿心脏动力学的方法；然而，需要对该方法的诊断应用进行验证，以确定其对新生儿心脏动力学的诊断能力，从而区分正常与病理动力学。从0至10日龄的新生儿中选取了39份连续动态心电图记录，记录时长至少为21小时，其中9例临床检查结果正常，30例患有心脏疾病，获取了每小时的心率最大值和最小值。计算了心率在每分钟5次跳动范围内出现的概率。分析了概率分布，最后通过物理数学方法确定诊断结果。然后，对敏感性、特异性和诊断一致性进行了统计验证。正常记录显示，心率在每分钟125至135次范围内的概率分布不存在或极少出现，而异常记录在这些范围内有值，并且心率在每分钟75至85次范围内不存在或极少出现。敏感性和特异性均为100%，卡帕系数值为1。由此得出结论，通过应用新生儿心脏诊断的物理数学方法，可以区分正常与疾病状态。
