Agreement between artificial neural networks and experienced electrocardiographer on electrocardiographic diagnosis of healed myocardial infarction

Department of Clinical Physiology, Lund University, Sweden.

OBJECTIVES: The purpose of this study was to compare the diagnoses of healed myocardial infarction made from the 12-lead electrocardiogram (ECG) by artificial neural networks and an experienced electrocardiographer. BACKGROUND: Artificial neural networks have proved of value in pattern recognition tasks. Studies of their utility in ECG interpretation have shown performance exceeding that of conventional ECG interpretation programs. The latter present verbal statements, often with an indication of the likelihood for a certain diagnosis, such as "possible left ventricular hypertrophy." A neural network presents its output as a numeric value between 0 and 1; however, these values can be interpreted as Bayesian probabilities. METHODS: The study was based on 351 healthy volunteers and 1,313 patients with a history of chest pain who had undergone diagnostic cardiac catheterization. A 12-lead ECG was recorded in each subject. An expert electrocardiographer classified the ECGs in five different groups by estimating the probability of anterior myocardial infarction. Artificial neural networks were trained and tested to diagnose anterior myocardial infarction. The network outputs were divided into five groups by using the output values and four thresholds between 0 and 1. RESULTS: The neural networks diagnosed healed anterior myocardial infarctions at high levels of sensitivity and specificity. The network outputs were transformed to verbal statements, and the agreement between these probability estimates and those of an expert electrocardiographer was high. CONCLUSIONS: Artificial neural networks can be of value in automated interpretation of ECGs in the near future.

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