The current standards for shock advisory algorithms in AEDs require performance testing on artifact-free ECGs. However, AED analysis in the real world is more challenging due to potential artifacts from various sources (e.g., patient handling, and electromagnetic interference). This retrospective data analysis reports the real-world performance and behavior of a shock advisory algorithm used in three AED models with the presence of artifacts. ECG rhythm analyses recorded during the use of three AED models (HS1, FRx and FR3) were reviewed. The shock recommendations made in the AEDs were compared to the expert annotations of reviewers. The effects of real-world artifacts and the handling by the algorithm were analyzed. Among the 3,941 analyses, 619 were annotated as shockable rhythms, and 2,912 were non-shockable. The overall sensitivity and specificity were 97.1% (601/619), and 99.9% (2,908/2,912), respectively. Artifacts were detected by the algorithm in 23.3% (918/3,941) of the analysis periods. The algorithm performance for the analysis periods with artifacts detected was 95.2% (80/84) for sensitivity and 100.0% (687/687) for specificity. In the remaining analysis periods with no artifacts detected, the sensitivity was 97.4% (521/535), and specificity was 99.8% (2,221/2,225). The performance of this shock advisory algorithm during real-world resuscitations with or without artifacts, exceeded AHA recommendations and the requirements in international standards. The high sensitivity and specificity demonstrate the effectiveness and safety of this algorithm in all three AED models.

中文翻译：

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在存在真实伪影的情况下，自动体外除颤器中的电击咨询算法的诊断准确性

AED 电击咨询算法的当前标准要求对无伪影心电图进行性能测试。然而，由于各种来源（例如，患者处理和电磁干扰）的潜在伪影，现实世界中的 AED 分析更具挑战性。这项回顾性数据分析报告了三个 AED 模型中使用的电击咨询算法的真实性能和行为，并且存在伪影。回顾了使用三种 AED 模型（HS1、FRx 和 FR3）期间记录的心电图节律分析。 AED 中提出的休克建议与审阅者的专家注释进行了比较。分析了现实世界伪影的影响和算法的处理。在 3,941 项分析中，619 项被注释为可电击节律，2,912 项被注释为不可电击节律。总体敏感性和特异性分别为 97.1% (601/619) 和 99.9% (2,908/2,912)。该算法在 23.3% (918/3,941) 的分析周期中检测到伪影。检测到伪影的分析周期的算法性能灵敏度为 95.2% (80/84)，特异性为 100.0% (687/687)。在未检测到伪影的其余分析期间，敏感性为 97.4% (521/535)，特异性为 99.8% (2,221/2,225)。这种电击咨询算法在有或没有伪影的现实复苏过程中的性能超出了 AHA 建议和国际标准的要求。高灵敏度和特异性证明了该算法在所有三种 AED 模型中的有效性和安全性。