Reliability-based rearrangement of electrocardiographic automated interpretation chain

Minnesota Coding were added. The data were first stratified by matching for sex and then age (in 10-year groupings), and then individuals were randomly allocated to either a training or evaluation set. Results: In the group as a whole, 4 codes (3-1, 3-3, 9-2 anterior, and 9-5) were found to have specificity levels below 95% in men, although these codes were highly specific in women. A sex analysis of the 4 codes showed a significantly larger proportion of men having the codes than women (P b .001). With respect to age, the specificity level in men younger than 40 years (n = 466) was significantly lower than that in the group of men older than 40 age (n = 389) for each code under examination (P b .001). The criteria in the 4 groups were altered to increase specificity toward the 95% level (see table). After the optimization process, specificity for men increased across all 4 codes in the test set, with improvement levels ranging from 2.8% for code 3-1 to 12.9% for code 9-2 anterior. Conclusions: The study showed that specificity levels for some voltage-related Minnesota codes are age-and sex-dependent. Although specificity of the revised criteria applied to the test set was disappointing, compared to those obtained using the training set, there was always an improved specificity up to 12.9% using the revised age-based criteria for men. Users of the Minnesota code should be aware of its lack of specificity in younger men in particular. Diagnostic value of exercise electrocardiogram in elderly patients with suspected coronary artery disease Introduction: The aim of this study was to define the diagnostic value of 12-lead exercise electrocardiography (ECG) in elderly patients for whom coronary angiography was planned for diagnosis of coronary artery disease (CAD). Methods: A selected series of 196 patients older than 64 years (124 men, mean age 75.6 years; 72 women, mean age 67.6 years) hospitalized because of suspected CAD underwent exercise ECG and coronary angiography, respectively. The sensitivity, specificity, and positive and negative predictive values of exercise ECG were calculated. Patients unable to develop an adequate exercise workload were not taken into account. Results: Between the total of 196 patients, 128 (65.3%) could reach the adequate exercise workload (66.1% of men and 63.9% of women). Exercise ECG results were positive in 102, and coronary angiography confirmed the presence of CAD in 90 of them; results were negative in 26 …