An on-line computerized ECG program for the prediction of acute ischemic heart disease

A logistic regression-based predictive instrument (PI) was developed to compute an emergency room (ER) patient´s likelihood of acute cardiac ischemia (ACI) on the basis of clinical presentation and ECG (electrocardiography). The purpose of this study was to incorporate the PI into a computerized ECG so that a patient´s probability of ACI could be provided automatically in real time with the ECG. The authors modified the original PI´s variables to use the capabilities of a computerized ECG and programmed the PI´s formula and variables into a Hewlett-Packard ECG using Electrocardiographic Language. Between the ECG and an electrocardiographer there was 85% testing agreement on the exact classification and measurement of ECG waveforms and agreement within 2% for the calculated probability of ACI. This application has considerable promise as a real-time decision aid for ER triage