What ECG Computer Program to Choose for Clinical Application: The Need for Consumer Protection

ALTHOUGH first attempts to automate ECG analysis go back to the late 1950s,1-3 serious clinical application is a development of only the recent past. It appears that at present the greatest need for automated ECG interpretation exists in large city hospitals where the ever-increasing number of ECG recordings is overtaxing the relatively fixed supply of trained electrocardiographers and in rural areas where specialists with adequate expertise are frequently spread out too thin. In these situations, assistance through automation appears desirable and deserves support. The number of commercial firms providing partially or completely automated ECG interpretations in response to this need has mushroomed to the point where it is estimated that there are close to 50 at this time in the U. S. alone. A variety of competing commercial ECG computer programs is being offered, accompanied by claims of excellent diagnostic performance and embellished with statements on the "infallibility" of the computer. The physician considering computerized ECG analysis must choose between one of the available systems in the midst of these many claims and counterclaims. Conferences on ECG computer analysis have most often increased rather than decreased the prevailing confusion. A further problem presented to potential users deals with so-called "certified"