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Biomedical subjects

J A Milliken

Publications and source records attributed to J A Milliken.

8 recordsLinked to original sources
PubMed1978

Detection of pericardial effusion by chest roentgenography and electrocardiography versus echocardiography.

To determine the sensitivity and specificity of chest roentgenography and electrocardiography in the detection of pericardial effusion, echocardiography was used as the diagnostic standard. Chest roentgenograms and electrocardiograms of 124 patients, 57 of whom had pericardial effusion, were read without knowledge of the echocardiographic interpretation. The sensitivity of roentgenographic diagnosis was low (20%), as was that of diagnosis from decreased voltage on the electrocardiogram (26%). The specificity of the chest roentgenogram was 89% and that of the low-voltage electrocardiogram 97%. The high specificity of the low-voltage electrocardiogram may have been due in part to the exclusion of obese and emphysematous subjects from the study. When cardiomegaly detected roentgenographically or a low-voltage electrocardiogram or both were considered as evidence of pericardial effusion, sensitivity improved to 82% but specificity declined to 29%. It is concluded the chest roentgenography and electrocardiography are unsatisfactory as screening investigations for the detection of pericardial effusion.

Echocardiography↗
PubMed1978

Assessment of the technical quality of electrocardiograms.

The technical quality of 600 electrocardiograms (ECG's) was assessed for missing leads and clipping, and graded from 1 to 5 for each of noise, lead drift and beat-to-beat drift. Three subgroups of 200 ECGs each were studied: group A, those obtained by emergency department staff (non-technicians); group B, records obtained by ECG technicians; and group C, telephone-transmitted records obtained by technicians performing all the laboratory work at a smaller, outlying hospital. Records with missing leads, clipping, grade 4 or 5 noise, grade 5 lead drift or grade 5 beat-to-beat drift were classified as unsatisfactory or rejected. With these stringent criteria the rejection rate was 71.0% for group A records, 58.5% for group B and 44.5% for group C. The proportions of records with peak quality (no missing leads or clipping, and grade 1 noise, lead drift or beat-to-beat drift) were 4.5% for group A, 5.5% for group B and 23.0% for group C. Suggested revisions in the grading of technical quality of ECGs are presented.

Allied Health Personnel↗
PubMed1977

The impact of the computer-reported vectorcardiogram on the cardiologist interpreter of the scalar electrocardiogram.

The purpose of this study was to determine if the computer-reported vectorcardiogram (VCG) had a notable impact on the cardiologist interpreter of the 12-lead scalar electrocardiogram (ECG). Three cardiologists read 100 12-lead scalar ECGs and four months later again read the same tracings while having available the VCG computer report. The diagnosis was altered in 25% of the repeated interpretations. Forty-five per cent of these had only minor changes and can probably be disregarded. Major or significant changes occurred in 14% of the records, and 80% of these were apparently attributable to the computer report. It was concluded that the use of a computer-assisted interpretation of a VCG may enhance the uniformity and consistency of the cardiologist's interpretation of the scalar ECG.

Bundle-Branch Block↗