Table 2.
Rhythm detection performance of AED shock advisory systems during CPR in clinical studies: Comparison of AWC vs. cprINSIGHT algorithms (results are computed from data in original article).
| This study | De Graaf et al. (2021)19 | |
|---|---|---|
| AED used for data collection | DEFIGARD Touch7 DGT7 (SCHILLER Médical) |
Lifepack CR2 (STRYKER) |
| Name of the algorithm (study type) | AWC (clinical) | cprINSIGHT (clinical) |
| Strategy of the embedded algorithm | To improve the treatment of refibrillation (administer an early shock in shockable patients) | To provide continuous CPR at 2-minutes for non-shockable patients |
| Number of patients | 285 | 365 |
| Number of analysis strips (validation dataset) |
2412 | 726* |
| Duration of analysis during CC (Step 1) |
16 s | 30 s |
| Duration of analysis during reconfirmation (Step 2) |
5 s | 10 s |
| Confirmation rate** |
27.7% (557/2011) |
29.6% (215/726) |
| Performance of analysis during clean ECG: Standard analysis | ||
| VF (Sensitivity) | 100% (283/283) | |
| NSR (Specificity) | 100% (16/16) | NA |
| ONR (Specificity) | 96.8% (150/155) | |
| ASYS (Specificity) | 97.6% (82/84) | |
| Performance of regular analysis in presence of chest compressions (Step 1) | ||
| VF (Sensitivity) | 92.9% (380/409) | 81.8% (90/110) |
| NSR (Specificity) | NA (0/0) | NA (0/0) |
| ONR (Specificity) | 95.2% (885/930) | 78.2% (169/216) |
| ASYS (Specificity) | 86.5% (463/535) | 60.3% (240/398) |
| Performance of reconfirmation analysis in absence of chest compressions (Step 2) | ||
| VF (Sensitivity) | 98.4% (374/380) | 100% (15/15) |
| NSR (Specificity) | NA (0/0) | NA (0/0) |
| ONR (Specificity) | 93.3% (42/45) | 97.8% (46/47) |
| ASYS (Specificity) | 100% (72/72) | 97.4% (148/152) |
| Performance of analyses sequence (Step 1 + Step 2) | ||
| VF (Sensitivity) | 91.4% (374/409) | 95.4% (105/110) |
| NSR (Specificity) | NA (0/0) | NA (0/0) |
| ONR (Specificity) | 99.7% (927/930) | 99.5% (215/216) |
| ASYS (Specificity) | 100% (535/535) | 97.5% (388/398) |
| All rhythms (Accuracy)*** | 98.0% (1836/1874) | 97.8% (708/724) |
| Global shock advisory system performance: Standard analysis + AWC (Step 1 + Step 2) | ||
| VF (Sensitivity) | 94.9% (657/692) | |
| NSR (Specificity) | 100% (16/16) | NA |
| ONR (Specificity) | 99.3% (1077/1085) | |
| ASYS (Specificity) | 99.7% (617/619) | |
NA: Not applicable or not reported; VF: Ventricular fibrillation; NSR: Normal sinus rhythm; ONR: Other non-shockable rhythm; ASYS: Asystole.
The number of strips represents all cases analyzed in Step 1 plus two pulseless ventricular tachycardias for which performance was not disclosed.
Confirmation rate is estimated as the percentage of cases needing a confirmation analysis (Step 2) among all analyses during CC (Step 1).
Accuracy related to performance of analyses sequence (Step 1 + Step 2) is the sum of true positives and true negatives divided by the total number of analysis strips.