Detection of ischaemic heart disease by electrocardiography in clinical practice and in mass population studies. Comparative investigation.

Two groups of epidemiologists (in Moscow and Prague) and a group of clinicians in Moscow evaluated independently of each other 283 electrocardiograms. Comparison has shown considerable agreement in the views of epidemiologists of both groups, especially as regards evaluation of cicatricial changes in the myocardium and of ischaemic-type T-wave changes. Intra-group differences in the evaluation of ECG signs of IHD were among epidemiologists substantially smaller than among clinicians. ECG criteria of IHD signs, used by epidemiologists, have a higher specificity than clinical criteria but smaller sensitivity, which corresponds to the demands placed on cross-sectional mass population studies. Possibilities were further examined of using a computer for automated ECG analysis. Comparison of the evaluations of 388 ECGs by two specialists and a computer showed a high proportion of true positive findings of marked cicatricial (93.3%) and ischaemic-type (63.7-76.4%) changes in the myocardium, detected by a Siemens computer.