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Biomedical subjects

P Rubel

Publications and source records attributed to P Rubel.

11 recordsLinked to original sources

Quantitative assessment of 12-lead ECG synthesis using CAVIAR.

The objective of this study is to assess the performance of patient-specific segment-specific (PSSS) synthesis in QRST complexes using CAVIAR, a new method of the serial comparison for electrocardiograms and vectorcardiograms. A collection of 250 multi-lead recordings from the Common Standards for Quantitative Electrocardiography (CSE) diagnostic pilot study is employed. QRS and ST-T segments are independently synthesized using the PSSS algorithm so that the mean-squared error between the original and estimated waveforms is minimized. CAVIAR compares the recorded and synthesized QRS and ST-T segments and calculates the mean-quadratic deviation as a measure of error. The results of this study indicate that estimated QRS complexes are good representatives of their recorded counterparts, and the integrity of the spatial information is maintained by the PSSS synthesis process. Analysis of the ST-T segments suggests that the deviations between recorded and synthesized waveforms are considerably greater than those associated with the QRS complexes. The poorer performance of the ST-T segments is attributed to magnitude normalization of the spatial loops, low-voltage passages, and noise interference. Using the mean-quadratic deviation and CAVIAR as methods of performance assessment, this study indicates that the PSSS-synthesis algorithm accurately maintains the signal information within the 12-lead electrocardiogram.

Electrocardiography

A standard communications protocol for computerized electrocardiography.

In an international collaborative project aimed at producing common standards for quantitative electrocardiography, a standard communications protocol (SCP-ECG) was developed for computerized electrocardiography. The protocol consisted of standards for the interchange, encoding, and storage of digital ECG data. The work was performed in three distinct, but closely related, work-packages and in close collaboration with representatives from 13 manufacturers of computerized electrocardiographs from all over the world. The objectives and results of SCP-ECG are briefly described in this paper.

Computer Communication Networks

Methodology of ECG interpretation in the Lyon program.

To provide an in-depth interpretation of the spatial QRS-T contour, we established a set of vectorcardiographic parameters computed octant by octant. For each statement the criteria constitute a model which is closely related to pathophysiological patterns. The diagnostic strategy is of the heuristic type. For each diagnosis a table lists several criteria providing both specific and differential diagnostic information. Inter-table competition is handled by specific logic. The program classifies diagnoses according to the number of non-satisfied criteria. Three versions are available including 124, 51 and 7 diagnoses, respectively. The first, intended for interpretation of complex situations, has given satisfactory results in such situations. Rhythm analysis is performed from 8-second recordings. All functions--acquisition, quality control, choice of a dominant complex, wave recognition, parameter extraction, interpretation, editing, storage--are integrated into a mobile cart. A complementary program performs serial analysis of successive tracings. It highlights with great precision morphological changes in the spatial loops and interval variations.

Diagnosis, Computer-Assisted

Value of scatter-graphs for the assessment of ECG computer measurement results.

A new method is presented, different from usual methods, for the discussion of the results of computer ECG measurement programs, based on a new graphical evaluation method. The proposed "scatter-graphs" both highlight the main program results and facilitate the comparison between various wave-recognition algorithms. They allow the distinction between the reliability of an algorithm, which is its capacity to provide a maximum of measurements with a minimum amount of errors, and its precision, i.e., the standard deviation of the differences between its point estimates and the reference. The method proves to be a powerful tool for the discussion of individual, as well as the median program results in CSE Measurement Study. It allows to highlight limitations induced in performance assessment by the variability of the reference itself, and to state that the median program is at least as close to the "Gold Standard" as the median of the referees.

Algorithms

Planarity of the spatial QRS loop. Comparative analysis in normals, infarcts, ventricular hypertrophies, and intraventricular conduction defects.

An almost perfect planarity of the spatial QRS loop is known as a characteristic of normal hearts. The Lyon VCG program routinely computes an original planarity index based on the relative magnitude of a so-called geometrical area vector (GAV%). It provides an indirect assessment of any kind of loop distortion (distorted segments lying outside the preferential plane, concavities, figures of eight, narrow configuration). Mean intraindividual variations of GAV%, studied in three different conditions, showed its relatively good stability. Eleven groups totaling 1,435 subjects were investigated. The highest GAV% values (mean, 88%) and the smallest scatter (sigma = 7) were found in normal tracings. GAV% was lower in right (mean, 82%) and left (76-82%) ventricular hypertrophies, in inferior (82%) and anterior (61%) myocardial infarctions, and in right (55%) and left (49%) bundle branch blocks. The diagnostic value of this index was tested for the normal-abnormal discrimination. Using a threshold of 80%, specificity was 89.6%, sensitivity was 78.6% for anterior myocardial infarction, right BBB was 86.6%, left BBB was 91.0% and other groups had unsatisfactory sensitivity. Poor correlations were observed with six other structural parameters, demonstrating that GAV% is relatively independent and may provide new diagnostic information.

Adolescent

CAVIAR: a serial ECG processing system for the comparative analysis of VCGs and their interpretation with auto-reference to the patient.

The authors present a new computer program for serial ECG analysis that allows a direct comparison of any couple of three-dimensional ECGs and quantitatively assesses the degree of evolution of the spatial loops as well as of their initial, central, or terminal sectors. Loops and sectors are superposed as best as possible, with the aim of overcoming tracing variability of nonpathological origin. As a result, optimal measures of evolution are computed and a tabular summary of measurements is dynamically configured with respect to the patient's history and is then printed. A multivariate classifier assigns each couple of tracings to one of four classes of evolution. Color graphic displays corresponding to several modes of representation may also be plotted.

Data Display

Display of the vectorcardiograms with a new complementary loop of formula Z = f (square root X2 + Y2).

It is important in vectorcardiography to be able to determine the position and magnitude of a given vector, e.g., the left maximum spatial vector, or the vector occurring 20 ms after beginning of QRS, etc. In this aim the authors present besides the three classical planar projections , a fourth curve of Lissajous, known asthe "modulus curve" and which corresponds to the formula Z = f (square root X2 + Y2). In general applications, this curve is very simple to use, and several examples of application are given. The technical realization, which involves no great modification of standard equipment, is described.

Computers, Analog

[A system to aid decision-making. Application to automatic interpretation of vectorcardiograms].

This paper presents a complete and autonomous system for the automated diagnosis (heuristic approach). The system was worked out by means of a small computer. A flexible, evolutive, quasi-universal system is achieved through original procedures. A specialised language enables the users to describe diagnoses and their criteria in symbolic form. A suitable compiler translates this symbolic writing into an interpretable object program. This, with the Interpreter program, constitutes the 'Automated Diagnosis Program'. Our data are vectorcardiograms recorded according to the Frank orthogonal system. After an interactive pre-processing process, 180 parameters--mostly spatial--are computed. The data, the computed parameters and additional information are stored in a data bank. Finally, the medical interpretation is automatically selected from 125 possibilities. The user could also utilise a data bank interrogation language.

Computers