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PubMed1976

[Visual processing of 12,000 electrocardiograms according to the USPHS code and comparison of visual and automatic processing of about 6,000 electrocardiograms in accordance with the USPHS code].

Multistage screening in Hesse (W. Germany) and the visual processing of about 12,000 ECG's in accordance with the USPHS (Riedel programme) are reported. A good fit was found with data obtained from a similar study in another part of the country. Comparison is then made with the visual and computerised processing of about 6,000 ECG's in accordance with the same code, using four classes: "normal", "conditionally within the limits of normal", "suspect" and "definitely pathological". The encouraging result on comparison between "normal" and "pathological" in the 6.3% consisting of false negatives (only 2.1% definitely pathological) suggests that "normal" and "conditionally normal" ratings by the computer can be accepted, whereas considerable possibilities for cardiological diagnosis would remain in the case of pathological traces, which would always be accepted, where as considerable possibilities recognised standards set down by the USPHS code are considered reliable. They can be used under hospital or screening conditions. On the other hand, the "scale of values" programme offered as a model requires further checking. Notes on future development are also offered.

Coronary Disease↗
PubMed1981

Value of exercise thallium-201 imaging in patients with diagnostic and nondiagnostic exercise electrocardiograms.

The role of exercise imaging with thallium-201 in the evaluation of patients suspected of having coronary artery disease was studied in 194 patients undergoing diagnostic coronary arteriography. Ninety-eight patients had 70 percent or more narrowing of one or more coronary vessels and 96 patients had either no or insignificant coronary artery disease. One hundren twenty-three of the 194 patients had conclusive treadmill exercise electrocardiograms (either positive or negative), and 71 had inconclusive exercise electrocardiograms. Fifty-four of the 98 patients with coronary artery disease were receiving propranolol at the time of testing. Forty-five (83 percent) of the 54 patients receiving propranolol and 33 (75 percent) of the 44 patients not receiving propranolol had abnormal exercise thallium images (difference not significant). In patients with conclusive exercise electrocardiograms the sensitivity of exercise imaging was not significantly different from that of exercise electrocardiograms (80 versus 74 percent), but the sensitivity of both tests combined (92 percent) was higher than that of either test alone (p less than 0.01). The specificity of exercise imaging (97 percent) electrocardiograms the sensitivity of exercise imaging was not significantly different from that of exercise electrocardiograms (80 versus 74 percent), but the sensitivity of both tests combined (92 percent) was higher than that of either test alone (p less than 0.01). The specificity of exercise imaging (97 percent) electrocardiograms the sensitivity of exercise imaging was not significantly different from that of exercise electrocardiograms (80 versus 74 percent), but the sensitivity of both tests combined (92 percent) was higher than that of either test alone (p less than 0.01). The specificity of exercise imaging (97 percent) was higher than that of exercise electrocardiograms (86 percent, p less than 0.02). The specificity of both tests combined was not significantly different from that of exercise electrocardiograms alone. The sensitivity (79 percent) and specificity (95 percent) of exercise imaging were not significantly different in patients with inconclusive exercise electrocardiograms when compared with those in patients whose exercise electrocardiograms were conclusive. These data indicate that exercise imaging is sensitive and specific in diagnosing coronary artery disease in the presence of diagnostic as well as nondiagnostic exercise electrocardiograms and that propranolol therapy does not affect the results.

Angina Pectoris↗