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Methods Inf Med 1993; 32(01): 59-65
DOI: 10.1055/s-0038-1634889
Original Article
Schattauer GmbH

A New Method to Assess the Difficulty of a Medical Diagnosis: Application to Electrocardiographic Interpretation

P. Arnaud
1   Unit 121, National Institute of Health and Medical Research (INSERM), Lyon, France
,
J. L. Willems
2   Division of Medical Informatics, University of Leuven, Leuven, Belgium
,
P. Girard
3   Clinical Pharmacology Unit, Cardiovascular Hospital and INSERM, Lyon, France
,
D. Morlet
1   Unit 121, National Institute of Health and Medical Research (INSERM), Lyon, France
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Publikationsdatum:
06. Februar 2018 (online)

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Abstract:

A new method to assess the relative difficulty of a medical diagnosis and the efficacy of a diagnostic procedure is described. The cases within a population are classified by N independent interpreters, i. e., medical experts or computer programs. The percentages of correctly diagnosed cases by N (unanimity), N-1, N-2, ..., zero interpreters, respectively, are calculated. These Nl + 1 percentages are presented in a histogram. A cumulative plot is derived from the “unanimity” value. The ratio “unanimity value”/“zero value” is proposed as an index of diagnostic performance. An application to the CSE database is presented which is composed of 1,220 electrocardiographic tracings interpreted by 13 cardiologists and 15 computer programs. The cumulative plots, the performance index and Log (index) values, established for eight different diagnostic statements, clearly show the relative degree of diagnostic difficulty for each of them and the particular efficacy of each approach, i. e., electrocardiography versus vectorcardiography, and computerized versus human interpretation.

Key-words

Diagnostic Performance - Evaluation - Human Interpretation - Computer-assisted Interpretation - Electrocardiography - Vectorcardiography
 

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