Clifford A C
Institute for Biomedical Equipment Evaluation and Services, Sheffield, UK.
Resuscitation. 1996 Oct;32(3):217-25. doi: 10.1016/0300-9572(96)00973-2.
The sensitivity and specificity to ventricular fibrillation (VF) and ventricular tachycardia (VT), classified as requiring immediate DC shock, of four automated external defibrillators (AEDs) and three advisory defibrillators were assessed using the Department of Health Arrhythmia library. This library collected mostly from patients in hospital, includes a wide variety of ECG rhythms including many with additional noise and interference artefact. The library comprised 278 16-s rhythms, 59 of which were VF, 36 were VT requiring cardioversion and 183 were deemed non-shockable. Non-shockable rhythms included asystole, pacing, slow VT, idioventricular rhythms, sinus and atrial based rhythms, some of which contained ventricular ectopic activity of differing grades. For the AEDs, a positive result (indicating detection of a shockable rhythm) was recorded if charging started or was able to be started at any time during the 16 s of rhythm output and energy subsequently available for discharge. For the advisory defibrillators, a positive result was recorded if a 'shock advised' alert was issued at any time during output of the rhythm. The AEDs exhibited sensitivities to VF in the range 81-94%, and to VF plus shockable VT 64-73%, or 72-83% depending whether VT > 150 beats/min or > 180 beats/min is considered to be shockable. The specificities recorded were in the range 90-94% and 86-92%, respectively. All but one of the advisory defibrillators performed similarly. Excluding the artefact rhythms, specificities in the range 79-91% were obtained. All figures stated are at the lower limit of the 95% confidence interval.
使用卫生部心律失常库，对4台自动体外除颤器（AED）和3台咨询式除颤器针对心室颤动（VF）和室性心动过速（VT）（归类为需要立即进行直流电电击）的敏感性和特异性进行了评估。该库主要收集自住院患者，包含各种各样的心电图节律，包括许多带有额外噪声和干扰伪迹的节律。该库包含278个16秒的节律，其中59个是VF，36个是需要心脏复律的VT，183个被认为不可电击。不可电击的节律包括心搏停止、起搏、缓慢VT、心室自主节律、窦性和房性节律，其中一些包含不同级别的室性异位活动。对于AED，如果在节律输出的16秒内的任何时间开始充电或能够开始充电，并且随后有能量可供放电，则记录为阳性结果（表明检测到可电击节律）。对于咨询式除颤器，如果在节律输出期间的任何时间发出“建议电击”警报，则记录为阳性结果。AED对VF的敏感性范围为81% - 94%，对VF加可电击VT的敏感性为64% - 73%，或者根据是否将VT > 150次/分钟或> 180次/分钟视为可电击，敏感性为72% - 83%。记录的特异性分别在90% - 94%和86% - 92%的范围内。除了一台咨询式除颤器外，其他所有咨询式除颤器的表现相似。排除伪迹节律后，获得的特异性范围为79% - 91%。所有列出的数字均处于95%置信区间的下限。
