Establishment of a reference library for evaluating computer ECG measurement programs

• Published in: Computers and biomedical research Vol. 18; no. 5; pp. 439 - 457
• Main Authors: Willems, Jos L., Arnaud, Pierre, van Bemmel, Jan H., Bourdillon, Peter J., Degani, Rosanna, Denis, Bernard, Harms, Frits M.A., Macfarlane, Peter W., Mazzocca, Gianfranco, Meyer, Jürgen, Ritsema van Eck, Henk J., Robles de Medina, Etienne O., Zywietz, Christoph
• Format: Journal Article
• Language: English
• Published: San Diego, CA Elsevier Inc 01.10.1985; Academic Press
• Subjects: Biological and medical sciences; Computers - standards; Delphi Technique; Electrocardiography - methods; Electrocardiography - standards; Electrocardiography. Vectocardiography; Electrodiagnosis. Electric activity recording; Europe; Humans; International Cooperation; Investigative techniques, diagnostic techniques (general aspects); Japan; Medical sciences; North America; Reference Standards; Software - standards; Statistics as Topic; North America; Europe; Japan; Waveform; Biomedical data processing; Computer program; Databank; Standardization; Computerized processing; Electrocardiography; Electrophysiology; Pattern recognition; Diagnostic aid; Signal analysis
• ISSN: 0010-4809; 1090-2368
• DOI: 10.1016/0010-4809(85)90021-7

As a result of an international cooperative project entitled “Common Standards for Quantitative Electrocardiography” (CSE), an ECG reference data base has been established with the aim of standardizing computer-derived ECG measurements. The objective of the project is to reduce the wide variation in wave measurements currently obtained by ECG analysis programs. A library of 250 ECGs with selective ECG abnormalities was established and a comprehensive reviewing scheme was devised for the visual determination of the onsets and offsets of P, QRS, and T. This task was performed by a board of cardiologists on highly amplified, selected complexes from the library. A subset was examined in order to study beat-to-beat and intraobserver variability. By using a modified Delphi approach, individual outlying point estimates were eliminated in four successive rounds. In this way final referee estimates were obtained which proved to be highly reproducible and precise. A reference library has thereby been developed which allows testing of the performance of ECG measurement programs and is a useful instrument in establishing recommendations for more precise measurement rules and definitions.