Abstract
A simple objective screening method for diagnosis of the atrial septal defect (ASD) is needed. Acoustic signals were collected from 61 children with ASD and 60 with a physiological murmur. The second heart sound (S2) and the spectrum of systolic murmur were analysed. A statistical model was designed using stepwise logistic regression analysis. Significant variables distinguishing pathological form normal findings were the interval between the first heart sound and the beginning of systolic murmur or the respiratory variation of S2, and the frequency of the murmur at its maximum intensity. The area under the ROC curve was 0.922; indicating very good fit of the model and the confidence interval was 0.872–0.971. The sensitivity of the model was 91% and the specificity 73%. The analysis of acoustic findings from the heart is a valuable tool in diagnosing ASD. The next step will be automating this process.
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References
Breiman L (1984) Classification and regression trees. Wadsworth, Belmont
Campbell M (1970) Natural history of atrial septal defect. Br Heart J 32:820–826
Dasarathy B (1991) Nearest neighbor pattern classification techniques. IEEE Computer Society Press, Silver Spring
Dreiseitl S, Ohno-Machado L (2002) Logistic regression and artificial neural network classification models: a methodology review. J Biomed Inform 35(5–6):352–359
El-Segaier M, Lilja O, Lukkarinen S, Sörnmo L, Sepponen R, Pesonen E (2005) Computer-based detection and analysis of heart sound and murmur. Ann Biomed Eng 33(7):945–950
Ghaffarpour R, Ringertz H, Rudhe U, Wallgren G (1966) Roentgenologic heart volume determination in children. Lakartidningen 63(40):3764–3771
Gonen M (2006) Receiver operating characteristic (ROC) curves. In: Proceedings of the 31st annual SAS(R) users group international conference. SAS Institute Inc., Cary, pp 210–231
Hosmer DW, Lemeshow S (1989) Applied logistic regression, 3rd edn. Wiley, New York
Kmenta J (1986) Elements of econometrics. McGraw-Hill, New York, p 434
Lasko TA, Bhagwat JG, Zou KH, Ohno-Machado L (2005) The use of receiver operating characteristic curves in biomedical informatics. J Biomed Inform 38(5):404–415
Lukkarinen S, Noponen A-L, Sikio K, Angerla A (1997) A new phonocardiographic recording system. Comput Cardiol 24:117–120
McConnell ME, Adkins SB 3rd, Hannon DW (1999) Heart murmurs in pediatric patients: when do you refer? Am Fam Physician 60(2):558–565
Moss AJ, Adams FH (1998) Heart disease in infants, children, and adolescents, 5th edn. Williams, Baltimore, pp 687
O’Toole JD, Reddy PS, Curtiss EI, Shaver JA (1977) The mechanism of splitting of the second heart sound in atrial septal defect. Circulation 56(6):1047–1053
Pearson ES (1965) Studies in the history of probability and statistics. Xiv. Some incidents in the early history of biometry and statistics, 1890–94. Biometrika 52:3–18
Rangayyan RM, Lehner RJ (1987) Phonocardiogram signal analysis: a review. Crit Rev Biomed Eng 15(3):211–236
Selig MB (1993) Stethoscopic and phonoaudio devices: historical and future perspectives. Am Heart J 126(1):262–268
Stefani T, Otto D (1997) How classical are the clinical features of the “ostium secondum” atrial septal defect. Cardiol Young 7:294–301
Acknowledgments
We thank our research nurse, Laura O’Sullivan Darcy, for her help in organizing contact with the parents and children included in the study. We also thank Ola Lilja for his technical skill and support in signal processing and analysis.
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El-Segaier, M., Pesonen, E., Lukkarinen, S. et al. Atrial septal defect: a diagnostic approach. Med Bio Eng Comput 44, 739–745 (2006). https://doi.org/10.1007/s11517-006-0094-5
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DOI: https://doi.org/10.1007/s11517-006-0094-5