Comparison of an automated algorithm to expert physician interpretation of 80-lead body surface mapping in the evaluation of acute myocardial ischemia and infarction in patients presenting to the emergency department with chest pain: results from the Optimal Cardiovascular Diagnostic Evaluation Enabling Faster Treatment of Myocardial Infarction trial

J Electrocardiol. 2012 Nov-Dec;45(6):702-7. doi: 10.1016/j.jelectrocard.2012.07.002. Epub 2012 Sep 6.

Abstract

Introduction/background: Eighty-lead (80 L) body surface map (BSM) technology provides electrocardiogram data for the clinician to interpret. A BSM device also offers an automated interpretation. Little information is available about the performance of automated algorithm interpretation in comparison to human interpretation of the 80 L BSM.

Methods: Interpretations of BSMs by automated algorithm and a core laboratory of physician readers from The Optimal Cardiovascular Diagnostic Evaluation Enabling Faster Treatment of Myocardial Infarction trial were compared. The κ statistic and its 95% confidence interval for concordance were calculated. The effect of BSM quality on concordance was also analyzed.

Results: 3405 maps for 1601 subjects were reviewed by the core laboratory and automated algorithm. There was a combined concordance rate of 87.3% (κ = 0.46; 95% confidence interval, 0.40-0.52). A decrease in signal quality was associated with a decrease in concordance between human and automated algorithm interpretation (κ = 0.52 for good quality vs κ = 0.30 for poor quality).

Conclusion: A moderate degree of concordance was noted between physician and automated algorithm interpretation of 80 L BSMs. Signal quality of 80 L electrocardiographic BSM directly affected concordance.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Algorithms*
  • Body Surface Potential Mapping / methods*
  • Cohort Studies
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Humans
  • Male
  • Myocardial Ischemia / diagnosis*
  • Observer Variation
  • Pattern Recognition, Automated / methods*
  • Professional Competence*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Single-Blind Method