经皮冠状动脉介入治疗患者的心电图解释人机一致性:卡塔尔世界杯8强波胆分析回顾性数据分析研究%A Iftikhar,Aleeha %A Bond,Raymond %A Mcgilligan,Victoria %A Leslie,Stephen J %A Knoery,Charles %A Shand,James %A Ramsewak,Adesh %A Sharma,Divyesh %A McShane,Anne %A Rjoob,Khaled %A Peace,Aaron %+计算工程与建筑环境，阿尔斯特大学，贝尔法斯特约旦城，BT37 0QB，英国，44 7496635353，Iftikhar-a1@ulster.ac.uk %K心电图解释%K人机一致性%K经皮冠状动脉介入治疗初级服务%K急性心肌梗死%K扫描%K心电图%K心脏%K介入%K梗死%K人机%K诊断%D 2021 %7 2.3.2021 %9原文%J JMIR Med Inform %G英文%X当患者怀疑患有急性心肌梗死时，他们接受或拒绝经皮冠状动脉介入治疗，部分取决于他们的12导联心电图(ECG)和st段抬高心肌梗死标准的临床评估。目的:我们回顾性地确定了拒绝接受初级经皮冠状动脉介入治疗的患者的心电图(专家称为激活器护士)和计算机解释之间的一致性。方法:分析经皮冠状动脉介入治疗患者的各种特点。人为和计算机心电图解释都简化为“提示”或“不提示”急性心肌梗死，以避免分析复杂的异质和同义诊断术语。分析，以衡量一致性，并进行逻辑回归，以确定这些心电图解释(以及其他变量，如患者年龄，胸痛)是否可以预测患者死亡率。结果:1464例经皮冠状动脉介入治疗患者中，722例(49.3%)计算机诊断提示急性心肌梗死，634例(43.3%)人为诊断提示急性心肌梗死(P< 0.001)。1464名患者中有342名(23.3%)人与计算机一致认为可能存在急性心肌梗死。 However, there was a higher rate of human–computer agreement for patients not having acute myocardial infarctions (450/1464, 30.7%). The overall agreement rate was 54.1% (792/1464). Cohen κ showed poor agreement (κ=0.08, P=.001). Only the age (odds ratio [OR] 1.07, 95% CI 1.05-1.09) and chest pain (OR 0.59, 95% CI 0.39-0.89) independent variables were statistically significant (P=.008) in predicting mortality after 30 days and 1 year. The odds for mortality within 1 year of referral were lower in patients with chest pain compared to those patients without chest pain. A referral being out of hours was a trending variable (OR 1.41, 95% CI 0.95-2.11, P=.09) for predicting the odds of 1-year mortality. Conclusions: Mortality in patients who were declined for primary percutaneous coronary intervention was higher than the reported mortality for ST-elevation myocardial infarction patients at 1 year. Agreement between computerized and human ECG interpretation is poor, perhaps leading to a high rate of inappropriate referrals. Work is needed to improve computer and human decision making when reading ECGs to ensure that patients are referred to the correct treatment facility for time-critical therapy. %M 33650984 %R 10.2196/24188 %U https://medinform.www.mybigtv.com/2021/3/e24188 %U https://doi.org/10.2196/24188 %U http://www.ncbi.nlm.nih.gov/pubmed/33650984