Welch Allyn Cardioperfect Workstation, PEDMEANS ECG Interpretation Module - Physicians - User Manual - Manual (Page 8)

CardioPerfect Workstation
PEDMEANS ECG Interpretation Module Physicians Manual
DIR 80015051 Rev. C 8 / 55
or QRS duration > ULN
This means that the program will issue the statement “WPW” if delta waves are found in two or
more leads and either the PR interval or the QRS duration is greater than the upper limit of normal
for age. The upper limit of normal (ULN) and the lower limit of normal (LLN) denote the age-related
98th and 2nd percentile values, respectively, derived from the set of normal ECGs. Appendix A
gives a set of tables with normal limits for all parameters that are used in the program criteria.
The “and” and “or” operations in the should be applied to (sub)criteria has to be specified. As a rule,
when going over the criteria from right to left,
an “and” or “or” that is encountered should
immediately be applied to the (sub)criteria adjacent to it.
1.6 References
PEDMEANS is based on the Modular ECG Analysis System (MEANS) which has been developed
for computerized interpretation of adult ECGs. The main difference between PEDMEANS and
MEANS is their diagnostic logic which had to be completely redesigned for PEDMEANS. In several
publications, the program structure and signal analysis part of PEDMEANS and MEANS have been
described. One publication, which also provides many references for further reading, is:
•
Van Bemmel JH, Kors JA, Van Herpen G. Methodology of the modular ECG analysis
system MEANS. Methods Inf Med 1990;29:346-53.
The measurement and classification parts of MEANS have extensively been evaluated, both by the
developers themselves and by independent observers. A major evaluation study in the field of
automated electrocardiography has been the project Common Standards for Quantitative
Electrocardiology (CSE), in which about 15 ECG computer programs from all over the world have
participated. The CSE study consisted of two parts, one pertaining to the measurement part of the
ECG programs, the other to the diagnostic classification part. Two key references are:
•
Willems JL, Arnaud P, Van Bemmel JH, Bourdillon PJ, Degani R, Denis B, et al. A
reference database for multi-lead electrocardiographic computer measurement programs. J
Am Coll Cardiol 1987;10:1313-21.
• Willems JL, Abreu-Lima C, Arnaud P, Van Bemmel JH, Brohet C, Degani R, et al. The
diagnostic performance of computer programs for the interpretation of electrocardiograms.
N Engl J Med 1991;325:1767-73.
An initial report about the establishment of the normal limits used in PEDMEANS is provided in:
•
Rijnbeek PR, Witsenburg M, Schrama E, Kors JA. A new standard for the juvenile
electrocardiogram [abstract]. J Am Coll Cardiol 1999;33 Suppl:534A.