Decision support for the initial triage of patients with acute coronary syndromes

Clinical Physiology and Functional Imaging
Sven-Erik OlssonLars Edenbrandt

Abstract

Early revascularization of acute coronary syndromes improves the prognosis. It is of vital importance that the decision to treat the patient is taken as early as possible. The aim of this study was (i) to develop an automated tool for the analysis of electrocardiograms (ECGs) with regard to changes that indicate possible transmural ischaemia and (ii) to assess the influence of the tool on the ECG classifications of three interns with less than 12 months of experience in ECG reading. An artificial neural network was trained to automatically interpret ECGs using 3000 ECGs recorded at an emergency department. Thereafter, the performance of the network was evaluated using 1000 test ECGs. In the second step, three interns classified these test ECGs twice on different occasions, with and without the advice of the neural network. The gold standard was the classification made by two experienced cardiologists. On average, the three interns showed a sensitivity of 68% at a specificity of 92% without the advice of the neural network and a sensitivity of 93% at a specificity of 87% with the advice. The neural network itself showed a sensitivity of 95% at a specificity of 88%. The increase in sensitivity of 23-26% was significant (P<0.001) ...Continue Reading

Citations

Apr 20, 2014·BMC Emergency Medicine·Alexander KamaliUlf Ekelund
Jan 1, 2008·Computer Methods and Programs in Biomedicine·Robert F Harrison, R Lee Kennedy
Oct 22, 2008·International Journal of Medical Informatics·Joshua C DennyJoshua F Peterson
Feb 13, 2007·Journal of Electrocardiology·Michael GreenUlf Ekelund
Jan 29, 2011·The Journal of Cardiovascular Nursing·Lisa KuhnLinda Worrall-Carter
Apr 1, 2017·Archivos de cardiología de México·John SprockelEnrique González
Jan 5, 2021·Journal of the American College of Emergency Physicians Open·Abirami KirubarajanSameer Masood

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