A 29-point QRS scoring system achieved 98% specificity for identifying myocardial infarction when a score >2 was required, with at least 91% intra- and interobserver agreement.
Observational (n=50)
Does a 29-point QRS scoring system demonstrate high specificity and observer agreement for identifying myocardial infarction?
A simplified 29-point QRS scoring system from standard 12-lead ECGs demonstrates high specificity and excellent observer agreement for identifying myocardial infarction.
We evaluated a simplified version of a previously developed QRS scoring system for estimating infarct size using observations of Q- and R-wave durations and R/Q and R/S amplitude ratios in the standard 12-lead ECG. Groups of subjects with a minimal likelihood of having myocardial infarcts and minimal likelihood of having common noninfarction sources of QRS modification were studied to establish the specificity of each of the 37 criteria. Only two criteria required modification to achieve 95% specificity. These 37 criteria form the basis of a 29-point QRS scoring system. A 98% specificity was achieved when a score of more than 2 points was required to identify a myocardial infarct. Fifty patients were studied to determine the intra- and interobserver agreement with this scoring system. Each criterion achieved at least 91% intra- and interobserver agreement. These impressive levels of specificity and observer agreement must be matched by high sensitivity of the scoring system and a good correlation between the point score and infarct size in patients with proven infarcts if the point score is to be useful for detecting and sizing infarcts. Sensitivity and correlation between point score and infarct size are evaluated in later studies in this series. The standard ECG is inexpensive and can be obtained repetitively and noninvasively; its QRS complex may be an important means of estimating the size, presence and location of myocardial infarcts.
Wagner et al. (1982) conducted an observational in Myocardial infarction (n=50). QRS scoring system was evaluated on Specificity and intra- and interobserver agreement. A 29-point QRS scoring system achieved 98% specificity for identifying myocardial infarction when a score >2 was required, with at least 91% intra- and interobserver agreement.