The Bayesian Approach Improves the Electrocardiographic Diagnosis of Broad Complex Tachycardia
| Autor: | Michael Griffith, R K Pathamanathan, G A Ng, Ernest W. Lau, J Cooper, J D Skehan |
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| Rok vydání: | 2000 |
| Předmět: |
Tachycardia
Bayesian probability Bayesian inference Ventricular tachycardia Sensitivity and Specificity Electrocardiography Bayes' theorem Tachycardia Supraventricular medicine Humans cardiovascular diseases Medical diagnosis Observer Variation medicine.diagnostic_test business.industry Bayes Theorem Signal Processing Computer-Assisted Pattern recognition General Medicine medicine.disease Tachycardia Ventricular Supraventricular tachycardia Artificial intelligence Medical emergency medicine.symptom Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business Algorithms |
| Zdroj: | Pacing and Clinical Electrophysiology. 23:1519-1526 |
| ISSN: | 1540-8159 0147-8389 |
| Popis: | Despite numerous attempts at devising algorithms for diagnosing broad complex tachycardia (BCT) on the basis of the electrocardiogram (ECG), misdiagnosis is still common. The reason for this may lie with difficulty in implementing existent algorithms in practice, due to imperfect ascertainment of ECG features within them. An attempt was made to approach the problem afresh with the Bayesian inference by the construction of a diagnostic algorithm centered around the likelihood ratio (LR). Previously studied ECG features most effective in discriminating ventricular tachycardia (VT) from supraventricular tachycardia with aberrant conduction (SVTAC), according to their LR values, were selected for inclusion into a Bayesian diagnostic algorithm. A test set of 244 BCT ECGs was assembled and shown to three independent observers who were blinded to the diagnoses made at electrophysiological study. Their diagnostic accuracy by the Bayesian algorithm was compared against that by clinical judgement with the diagnoses from EPS as the criterial standard. Clinical judgement correctly diagnosed 35% of SVTAC, 85% of VT, and 47% of fascicular tachycardia. In comparison, by the Bayesian algorithm devised, 52% of SVTAC, 95% of VT, and 97% of fascicular tachycardia were correctly diagnosed. The Bayesian algorithm devised has proved to be superior to the clinical judgement of the observers who participated in this study, and theoretically will obviate the problem of imperfect ascertainment of ECG features. Hence, it holds the promise for being an effective tool for routine use in clinical practice. |
| Databáze: | OpenAIRE |
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