P.W. Macfarlane

Integration and communication for the continuity of cardiac care (I4C)

The project I4C (Integration and Communication for the Continuity of Cardiac Care) is carried out for the advancement of cardiac care, from prevention to follow-up. The goals of I4C are: (1) integrated access to patient data, wherever they are stored; (2) support of evidence-based care; (3) consistent recording of patient data (eg, patient history, electrocardiograms IECGs] or cine-angios) in a multimedia patient record; and (4) a documented reference data set for research. In several clinics, workstations are being installed to serve the four goals. Integration with other information systems in clinical care is realized by encapsulation. A computer-based patient record (ORCA) has been developed to support the collection, consultation, and sharing of patient data. In I4C, ORCA is intended for use in a research setting as well as routine patient care. The functionality of ORCA covers the collection of patient history data in a highly structured manner, the recording of drug prescriptions, an overview of laboratory test results, and viewers for ECGs and angiographic images. At present, structured data entry and consultation is supported in six European languages.

Comparison of diagnostic results of ECG computer programs and cardiologists

In the European concerted action Common Standards for Quantitative Electrocardiography (CSE) results of nine electrocardiography (ECG) and 6 vector cardiography (VCG) computer programs have been compared with a true diagnosis based on ECG-independent evidence, as well as to the results obtained by eight cardiologists who read the ECGs and five who read the VCGs. Results obtained in 1220 cases are presented. Assessment of the diagnostic performance of computer programs and of cardiologists against ECG-independent validated data was the primary objective. However, also testing against the readings of a group of cardiologists was performed to assess the clinical acceptability of the computer program results. The study shows that programs with the best performance reached almost equal levels to the best cardiologists. The study also shows that all can still be improved for one or more diagnostic categories, whereas some require general improvement.<<ETX>>

Common Standards for Quantitative Electrocardiography : The CSE Pilot Study

A four year concerted action project has been started in the European Communities (EC) with the aim of “Common Standards for Quantitative Electrocardiography” (CSE Project). Standards for computer derived ECG measurements are urgently required because more and more quantitative diagnostic ECG criteria are now being derived by ECG computer programs and in view of the existing differences, first of all with respect to time measurements of present computer programs.

Development Of A Standard Communications Protocol For The Exchange And The Storage Of Digital ECGs

In the SCP-ECG Project (AIM #1015) a standard communications protocol has been developed for computerized electrocardiography, consisting of standards and recommendations for the interchange, encoding and storage of digital ECG data. The work has been performed in three distinct, but closely related workpackages in close collaboration with representatives from academia and industry from all over the world. The objectives and results obtainedso far are described in the present paper.