Circulation, Vol 70, 255-262, Copyright © 1984 by American Heart Association
CR Brohet, A Robert, C Derwael, R Fesler, M Stijns, A Vliers and LA Braasseur
Statistical multivariate and conventional deterministic methods of
computerized interpretation of the electrocardiogram (ECG) were compared in
the analysis of 1711 pediatric orthogonal ECGs validated by
nonelectrocardiographic criteria on the basis of clinical and anatomic
diagnoses. Among 642 children catheterized for the evaluation of congenital
heart disease, there were 140 patients with left ventricular hypertrophy,
299 with right ventricular hypertrophy, and 203 with biventricular
hypertrophy. A group of 1069 obviously healthy school children was studied
as a control. The overall accuracy of multigroup ECG diagnosis was 85% and
79% for the statistical and deterministic methods, respectively. The
diagnostic performances of both methods expressed in terms of sensitivity
and predictive value were the highest for normal children and those with
right ventricular hypertrophy and lowest for children with biventricular
hypertrophy. The statistical method was more sensitive in the diagnosis of
left ventricular hypertrophy (74% vs 64%), right ventricular hypertrophy
(86% vs 83%), and biventricular hypertrophy (62% vs 50%). Mutual agreement
for a correct diagnosis by the two methods was 83% for normal children and
82% for those with right ventricular hypertrophy but only 61% for children
with left ventricular hypertrophy and 39% for those with biventricular
hypertrophy. In conclusion, better classification results are obtained with
statistical multivariate techniques as compared with conventional
deterministic analysis, but both methods of ECG interpretation are
complementary and their combination in the same electrocardiographic
computer program can improve diagnostic accuracy.
ARTICLES
Computer interpretation of pediatric orthogonal electrocardiograms: statistical and deterministic classification methods