passages: 3935
passages: document
passages: Methodology of serial ECG classification using an adaptation of the NOVACODE for Q wave myocardial infarction in the Bypass Angioplasty Revascularization Investigation ( BARI ) . Serial electrocardiographic ( ECG ) changes are a critical component of the diagnostic algorithm for classification of myocardial ischemic events in large-scale clinical trials . This study describes a computerized serial ECG classification program developed at the St. Louis University Core ECG Laboratory for use in the Bypass Angioplasty Revascularization Investigation ( BARI ) trial , in which patients with multivessel coronary artery disease were randomized to receive either coronary artery bypass grafting or percutaneous transluminal coronary angioplasty . The St. Louis University program detects and codes serial changes in Q , ST , and T wave items according to Minnesota code ( MC ) criteria using a modified NOVACODE hierarchical classification system . Measurements using a seven-power calibrated coding loupe are used to generate the MC from a customized software program . Significant minor or major changes are detected by the serial comparison program and referred to a physician coder for verification . Serial comparison coding rules are used to adjust for weaknesses in the standard MC classification system resulting from instability at decision boundaries . Of 4,244 BARI randomized and registry study participants with follow-up ECGs received at the Core ECG Laboratory as of March 1995 , a grade 2 MC Q wave progression was noted in 568 participants ( 13.4 % ) using MC criteria alone , as compared with 367 ( 8.6 % ) after the St. Louis University coding rules were applied . The incidence of grade 1 MC Q wave progressions was 16.4 % ( 697/4,244 ) versus 6.1 % ( 259/4,244 ) when the St. Louis University program was applied . Intraobserver variability for grade 2 Q wave progression codes determined from a sample of 812 serial .
entities: 3936
entities: Intervention_Surgical
entities: coronary artery bypass grafting
entities: 3937
entities: Intervention_Surgical
entities: percutaneous transluminal coronary angioplasty .
entities: 3938
entities: Outcome_Physical
entities: serial changes in Q , ST , and T wave items
entities: 3939
entities: Participant_Condition
entities: patients with multivessel coronary artery disease
entities: 3940
entities: Participant_Sample-size
entities: 4,244
entities: 3941
entities: Participant_Condition
entities: registry study participants with follow-up ECGs received at the Core ECG Laboratory as of March 1995