Diagnostic performance of a computer-based ECG rhythm algorithm.
We examined the accuracy of computer-based rhythm interpretation from one electrocardiograph manufacturer (GE Healthcare Technologies MUSE software 005C) in 4297 consecutive recordings in a university hospital setting. Overreading was performed by either of 2 experienced cardiologists, and all disagreements with the initial computer rhythm statement were reviewed by the second cardiologist to achieve physician consensus used as the "gold standard" for rhythm diagnosis. Overall, 13.2% (565/4297) of computer-based rhythm statements required revision, but excluding tracings with pacemakers, the revision rate was 7.8% (307/3954), including 3.8% involving the primary rhythm diagnosis and 3.9% involving definition of ectopic complexes. The false-negative rate for sinus rhythm was only 1.3%, but a computer diagnosis of sinus rhythm was incorrect in 9.9% of other rhythms. The false-negative rate for atrial fibrillation was 9.2%, whereas a computer diagnosis of atrial fibrillation was incorrect in 1.1% of other rhythms, including sinus. Computer diagnosis of paced rhythms remains problematic, and physician overreading to correct computer-based electrocardiogram rhythm diagnoses remains mandatory.
Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University and the Cornell Center of The New York-Presbyterian Hospital, New York, NY 10021, USA.
Kimble
K
Poon
Peter M
PM
Okin
Paul
P
Kligfield
D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis; D001282:Atrial Flutter / Q000175:diagnosis; D018880:Atrial Premature Complexes / Q000175:diagnosis; D005117:Cardiac Complexes, Premature / Q000175:diagnosis; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data; D003936:Diagnosis, Computer-Assisted / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005188:False Negative Reactions; D006327:Heart Block / Q000175:diagnosis; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D015588:Observer Variation; D010138:Pacemaker, Artificial; D012680:Sensitivity and Specificity; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis; D018879:Ventricular Premature Complexes / Q000175:diagnosis