A plea for common standards in computer aided ECG analysis.

Abstract Measurement results obtained by the AVA (3.6), TNO (7603), HP-5, IBM (version 2), and ECAN-D ECG computer programs have been compared, using digital data from 252 consecutive Frank and 12 lead ECG recordings. Considerable discrepancies were noted in the reporting of small Q and R waves. Substantial differences (DIF) were demonstrated in time measurements but not in amplitude results. Differences in results obtained upon analysis of odd and even data points were smaller in TNO and IBM, than in HP-5 results. Measurement DIF between ECG computer programs are not unexpected, even when identical digital data are used as input. Various programs apply different algorithms and references for wave recognition, beat selection and parameter extraction, leading to systematic and significant DIF in measurement results and ultimately also in diagnoses. A plea is made toward common standards, toward standardization of definitions of waves and measurement references.