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Papers/Automatic diagnosis of the 12-lead ECG using a deep neural...

Automatic diagnosis of the 12-lead ECG using a deep neural network

Antônio H. Ribeiro, Manoel Horta Ribeiro, Gabriela M. M. Paixão, Derick M. Oliveira, Paulo R. Gomes, Jéssica A. Canazart, Milton P. S. Ferreira, Carl R. Andersson, Peter W. Macfarlane, Wagner Meira Jr., Thomas B. Schön, Antonio Luiz P. Ribeiro

2019-04-02Electrocardiography (ECG)ECG ClassificationSpecificity
PaperPDFCode(official)

Abstract

The role of automatic electrocardiogram (ECG) analysis in clinical practice is limited by the accuracy of existing models. Deep Neural Networks (DNNs) are models composed of stacked transformations that learn tasks by examples. This technology has recently achieved striking success in a variety of task and there are great expectations on how it might improve clinical practice. Here we present a DNN model trained in a dataset with more than 2 million labeled exams analyzed by the Telehealth Network of Minas Gerais and collected under the scope of the CODE (Clinical Outcomes in Digital Electrocardiology) study. The DNN outperform cardiology resident medical doctors in recognizing 6 types of abnormalities in 12-lead ECG recordings, with F1 scores above 80% and specificity over 99%. These results indicate ECG analysis based on DNNs, previously studied in a single-lead setup, generalizes well to 12-lead exams, taking the technology closer to the standard clinical practice.

Results

TaskDatasetMetricValueModel
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.893DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.857DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.984DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.932DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.882DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.933DNN
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7764th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7694th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9474th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9174th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8824th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8964th year cardiology resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7325th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7065th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9155th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9285th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.755th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8575th year medical student
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7193rd year emergency resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.6963rd year emergency resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9123rd year emergency resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.8523rd year emergency resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8483rd year emergency resident
Electrocardiography (ECG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.9323rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.893DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.857DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.984DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.932DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.882DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.933DNN
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7764th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7694th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9474th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9174th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8824th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8964th year cardiology resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7325th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7065th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9155th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9285th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.755th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8575th year medical student
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7193rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.6963rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9123rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.8523rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8483rd year emergency resident
ECG ClassificationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.9323rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.893DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.857DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.984DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.932DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.882DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.933DNN
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7764th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7694th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9474th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9174th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8824th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8964th year cardiology resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7325th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7065th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9155th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9285th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.755th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8575th year medical student
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7193rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.6963rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9123rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.8523rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8483rd year emergency resident
Photoplethysmography (PPG)Electrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.9323rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.893DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.857DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.984DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.932DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.882DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.933DNN
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7764th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7694th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9474th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9174th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8824th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8964th year cardiology resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7325th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7065th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9155th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9285th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.755th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8575th year medical student
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7193rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.6963rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9123rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.8523rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8483rd year emergency resident
Blood pressure estimationElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.9323rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.893DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.857DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.984DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.932DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.882DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.933DNN
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7764th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7694th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9474th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9174th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8824th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8964th year cardiology resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7325th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.7065th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9155th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.9285th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.755th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.8575th year medical student
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (1dAVb)0.7193rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (AF)0.6963rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (LBBB)0.9123rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (RBBB)0.8523rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (SB)0.8483rd year emergency resident
Medical waveform analysisElectrocardiography (ECG) on Telehealth Network of Minas Gerais (TNMG)F1 (ST)0.9323rd year emergency resident

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