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A telediagnosis assistance system for multiple-lead electrocardiography

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Abstract

The diffusion of telemedicine opens-up a new perspective for the development of technologies furthered by Biomedical Engineering. In particular, herein we deal with those related to telediagnosis through multiple-lead electrocardiographic signals. This study focuses on the proof-of-concept of an internet-based telemedicine system as a use case that attests to the feasibility for the development, within the university environment, of techniques for remote processing of biomedical signals for adjustable detection of myocardial ischemia episodes. At each signal lead, QRS complexes are detected and delimited with the J-point marking. The same procedure to detect the complex is used to identify the respective T wave, then the area over the ST segment is applied to detect ischemia-related elevations. The entire system is designed on web-based telemedicine services using multiuser, remote access technologies, and database. The measurements for sensitivity and precision had their respective averages calculated at 11.79 and 24.21% for the leads of lower noise. The evaluations regarding the aspects of user friendliness and the usefulness of the application, resulted in 88.57 and 89.28% of broad or total acceptance, respectively. They are robust enough to enable scalability and can be offered by cloud computing, besides enabling the development of new biomedical signal processing techniques within the concept of distance services, using a modular architecture with collaborative bias.

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Data availability

The datasets analysed during the current study are available in European ST-T Database, available online by Physionet repository, https://physionet.org.

Notes

  1. Web application server developed by Red-Hat, formerly known as JBoss.

Abbreviations

API:

Application programming interface

DAO:

Data access objects

DBMS:

Database manager system

NIST:

National institute of standards and technology

HTML:

Hypertext markup language

JSF:

Java server faces

JSP:

Java server pages

JDBC:

Java database connectivity

JPA:

Java persistence API

MVC:

Model-view-controller

ORM:

Object relational mapping

RMI:

Remote method invocation

PROADI-SUS:

Support program for institutional development of the unified health system

URL:

Uniform resource locator

WFDB:

Waveform database

WWW:

World wide web

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Acknowledgements

This study received financial support from the Brazilian agencies FINEP and CNPq.

Funding

Funds from FINEP and CNPq agencies were used in the final revision of the text in English.

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Authors and Affiliations

  1. Instituto de Tecnologia, Universidade Federal do Pará, Belém, Brazil

    Paulo César Lucena Bentes

  2. Instituto Alberto Luiz Coimbra de Pós Graduação e Pesquisa de Engenharia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Jurandir Nadal

Authors
  1. Paulo César Lucena Bentes
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  2. Jurandir Nadal
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Contributions

PCLB carried out the research that gave rise to the method of processing biomedical signals, carried out the prospecting and execution of the computational techniques used, performed the tests with the signals and wrote the initial text of the article. JN guided all research and revised the entire text of the article.

Corresponding author

Correspondence to Paulo César Lucena Bentes.

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Conflict of interest

JN received financial support from the Brazilian agencies FINEP and CNPq.

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Bentes, P.C.L., Nadal, J. A telediagnosis assistance system for multiple-lead electrocardiography. Phys Eng Sci Med 44, 473–485 (2021). https://doi.org/10.1007/s13246-021-00996-2

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