Surgery – Diagnostic testing – Cardiovascular
Reexamination Certificate
2000-12-29
2003-12-16
Sykes, Angela D. (Department: 3762)
Surgery
Diagnostic testing
Cardiovascular
C600S513000
Reexamination Certificate
active
06665559
ABSTRACT:
BACKGROUND OF THE INVENTION
Physiological activity is monitored in the diagnosis and treatment of numerous diseases and medical conditions. For example, heart activity is commonly monitored by collecting electrocardiographic (“ECG”) data. ECG data is typically interpreted by a cardiologist, a physician specially trained in reading the waveforms created by ECG equipment.
In many situations, ECG and other physiological data is available, but an expert suitably trained in reading that data is not. In response to this problem, software interpretation tools have been developed to aid the non-expert physician in interpreting and using such data. However, these tools, particularly ECG tools, are not satisfactory. Existing ECG tools are designed to generate an interpretation. The computer-generated interpretation may be supported by one or more statements that describe the criteria that the computer uses to reach its conclusion. However, these statements are typically limited to describing the character of the waveform, which is usually of little assistance to the novice ECG reader. Another shortcoming of existing tools is that they generate conclusions based on the assumption that the ECG device correctly measured the ECG. In other words, existing computer tools assume that no faults or other errors ever occur in ECG measuring equipment.
The output from an existing ECG interpretation system is shown in FIG.
1
. The output includes a screen image
10
. The image
10
includes patient identifying information
12
, initial diagnostic information
14
, such as a complaint or symptom, measurements
16
, physiological data in the form of waveforms
18
, a diagnosis or interpretation
22
, and a group of reason statements
24
. In the example shown, the interpretation
22
indicates that there is a 42% probability that the patient has acute cardiac ischemia. The reasons supporting the interpretation are set out in the reason statements
24
. For example, the interpretation is based on the fact that the patient is male, complaining of chest pain, and that “no significant Q waves or primary ST segment abnormalities” were detected. The reason statements
24
also indicate that the “[a]nterior T waves” are flat.
Most non-specialists find reason statements such as those shown in
FIG. 1
to be too technical and, therefore, unhelpful in understanding the interpretation. Further, non-specialists are generally uncomfortable relying on an interpretation lacking a high probability. In the example shown, the interpretation generated has a probability of only 42%, meaning that there is a 58% chance that another interpretation is appropriate for the data. Thus, in those cases where present systems generate an interpretation of equivocal probability, they are often of little help.
Moreover, in cases where a patient is about to undergo a non-cardiac surgery, there is a need to be able to accurately assess the perioperative cardiovascular risk to the patient of performing the surgery. Again, having to wait for a cardiologist to make such an assessment may not be practical or even possible.
SUMMARY OF THE INVENTION
Accordingly, the invention provides real-time support in interpreting a patient's ECG in order to assess the perioperative cardiovascular risk associated with performing a non-cardiac surgery. An acquisition unit acquires the patient's ECG. A processor, coupled to the acquisition unit, determines whether the acquired ECG has diagnostic statements of cardiovascular risk. From the diagnostic statements, the processor determines the probability of cardiovascular risk associated with the non-cardiac surgery. The probability of cardiovascular risk is then displayed to a clinician in the form of an indicator of either major, intermediate, or minor cardiovascular risk.
The invention also provides a new method of interpreting a patient's ECG in order to assess the perioperative cardiovascular risk associated with performing a non-cardiac surgery. The method includes acquiring a patient's ECG, determining whether the ECG exhibits diagnostic statements of cardiovascular risk, and determining the probability of cardiovascular risk based on the diagnostic statements. The method also includes displaying the determined probability of cardiovascular risk to a clinician in the form of an indicator of either major, intermediate, or minor cardiovascular risk.
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Bradford Roderick
GE Medical Systems Information Technologies Inc.
Michael & Best & Friedrich LLP
Sykes Angela D.
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