The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

The history and challenges of SCP-ECG: the standard communication protocol for computer-assisted electrocardiography

Ever since the first publication of the standard communication protocol for computer-assisted electrocardiography (SCP-ECG), prENV 1064, in 1993, by the European Committee for Standardization (CEN), SCP-ECG has become a leading example in health informatics, enabling open, secure, and well-documented digital data exchange at a low cost, for quick and efficient cardiovascular disease detection and management. Based on the experiences gained, since the 1970s, in computerized electrocardiology, and on the results achieved by the pioneering, international cooperative research on common standards for quantitative electrocardiography (CSE), SCP-ECG was designed, from the beginning, to empower personalized medicine, thanks to serial ECG analysis. The fundamental concept behind SCP-ECG is to convey the necessary information for ECG re-analysis, serial comparison, and interpretation, and to structure the ECG data and metadata in sections that are mostly optional in order to fit all use cases. SCP-ECG is open to the storage of the ECG signal and ECG measurement data, whatever the ECG recording modality or computation method, and can store the over-reading trails and ECG annotations, as well as any computerized or medical interpretation reports. Only the encoding syntax and the semantics of the ECG descriptors and of the diagnosis codes are standardized. We present all of the landmarks in the development and publication of SCP-ECG, from the early 1990s to the 2009 International Organization for Standardization (ISO) SCP-ECG standards, including the latest version published by CEN in 2020, which now encompasses rest and stress ECGs, Holter recordings, and protocol-based trials

Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 260)

A bibliography containing 225 reports, articles, and other documents which were introduced into the NASA Scientific and Technical Information system in June 1984 is presented. All articles are indexed and abstracted. General topics include: life sciences, aerospace medicine, behavioral sciences, man/system technology and life support, and planetary biology

Electrocardiogram-based parameters for the prediction of sudden cardiac death: a review

There has recently been a resurgence of interest in electrocardiogram-based (ECG-based) parameters in predicting Sudden Cardiac Death (SCD) risk. Accurate and timely SCD predictions are essential clinical practice for physicians to provide effective prevention and treatment. An ECG is a non-invasive and inexpensive diagnostic test, and has been firmly established as a clinical tool for assessing the risk of cardiac disease. The electrocardiographic signal derived from the ECG recording consists of a distinctive waveform that depicts the electrical activity of the heart, which can be analyzed for the identification of abnormalities in the heart rhythm. The parameter or characteristic found in the ECG signal might be important for predicting the SCD. A number of systematic reports by expert meetings and review articles in indexed journals identified ECG-based parameters as QRS duration, QT interval, Signal Average ECG (SAECG), T-wave alternan (TWA), Heart Rate Variability (HRV), Heart Rate Turbulence (HRT), T-peak to T-end (Tpe), fragmented QRS complexes (fQRS), and Early Repolarization (ER). This article reviews the mechanism and morphology of these parameters, which may potentially have a role to play in a future algorithm designed to identify early signs of SCD. As of now, none of the ECG-based parameters have been found to be sufficiently stable to predict the SCD risk. Nevertheless, the combination of two or more of the parameters listed, as suggested in many studies, may become a useful component for predicting SCD in the future

Compelling new electrocardiographic markers for automatic diagnosis

Producción CientíficaBackground and Objective: The automatic diagnosis of heart diseases from the electrocardiogram (ECG) signal is crucial in clinical decision-making. However, the use of computer-based decision rules in clinical practice is still deficient, mainly due to their complexity and a lack of medical interpretation. The objetive of this research is to address these issues by providing valuable diagnostic rules that can be easily implemented in clinical practice. In this research, efficient diagnostic rules friendly in clinical practice are provided. Methods: In this paper, interesting parameters obtained from the ECG signals analysis are presented and two simple rules for automatic diagnosis of Bundle Branch Blocks are defined using new markers derived from the so-called FMM delineator. The main advantages of these markers are the good statistical properties and their clear interpretation in clinically meaningful terms. Results: High sensitivity and specificity values have been obtained using the proposed rules with data from more than 35000 patients from well known benchmarking databases. In particular, to identify Complete Left Bundle Branch Blocks and differentiate this condition from subjects without heart diseases, sensitivity and specificity values ranging from 93% to 99% and from 96% to 99%, respectively. The new markers and the automatic diagnosis are easily available at https://fmmmodel.shinyapps.io/fmmEcg/, an app specifically developed for any given ECG signal. Conclusions: The proposal is different from others in the literature and it is compelling for three main reasons. On the one hand, the markers have a concise electrocardiographic interpretation. On the other hand, the diagnosis rules have a very high accuracy. Finally, the markers can be provided by any device that registers the ECG signal and the automatic diagnosis is made straightforwardly, in contrast to the black-box and deep learning algorithms.Ministerio de Ciencia, Innovación y Universidades (grant PID2019-106363RB-I00

Applications of Automated Identification Technology in EHR/EMR

Although both the electronic health record (EHR) and the electronic medical record (EMR) store an individuals computerized health information and the terminologies are often used interchangeably, there are some differences between them. Three primary approaches in Automated Identification Technology (AIT) are barcoding, radio frequency identification (RFID), and biometrics. In this paper, technology intelligence, progress, limitations, and challenges of EHR/EMR are introduced. The applications and challenges of barcoding, RFID, and biometrics in EHR/EMR are presented respectively

Exploring risk pooling in hospitals to reduce demand and lead time uncertainty

Nearly every eighth German hospital faces an elevated risk of bankruptcy. An inappropriate use of inventory management practices is among the causes. Hospitals suffer from demand and lead time uncertainty, and the current COVID-19 pandemic worsened the plight. The popular business logistics concept of risk pooling has been shown to reduce these uncertainties in industry and trade, but has been neglected as a variability reduction method in healthcare operations research and practice. Based on a survey with 223 German hospitals, this study explores how ten risk pooling methods can be adapted and applied in the healthcare context to reduce economic losses while maintaining a given service level. The results suggest that in general risk pooling may improve the economic situation of hospitals and, in particular, inventory pooling, transshipments, and product substitution for medications and consumer goods are the most effective methods in the healthcare context, while form postponement may be unsuitable for hospitals due to the required efforts, delay in treatments, and liability issues. The application of risk pooling in healthcare requires willingness to exchange information and to cooperate, adequate IT infrastructure, compatibility, adherence to healthcare laws and regulations, and securing the immediate treatment of emergencies. Compared to manufacturing and trading companies, hospitals seem to currently neglect the variability reducing effect of risk pooling

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 145

This bibliography lists 301 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1975