TABLE 3.

Performances of deep learning‐based model for detecting electrolyte imbalance using electrocardiography

Deep learning‐based models (DLMs)	Internal validation (95% confidence interval)					External validation (95% confidence interval)
	AUC	SEN	SPE	PPV	NPV	AUC	SEN	SPE	PPV	NPV
Hyperkalemia
DLM using 12‐lead ECG	0.945 (0.931–0.959)	0.901 (0.807–0.959)	0.850 (0.843–0.856)	0.038 (0.030– 0.049)	0.999 (0.998–1.000)	0.873 (0.843–0.902)	0.896 (0.848–0.934)	0.599 (0.594– 0.604)	0.014 (0.012– 0.016)	0.999 (0.998–1.000)
DLM using 6‐lead ECG	0.908 (0.894–0.922)	0.915 (0.825– 0.968)	0.829 (0.822–0.836)	0.034 (0.027–0.044)	0.999 (0.998–1.000)	0.860 (0.831–0.888)	0.892 (0.842–0.930)	0.568 (0.560–0.570)	0.012 (0.011–0.014)	0.999 (0.998–1.000)
DLM using 1‐lead ECG	0.903 (0.888–0.918)	0.887 (0.790– 0.950)	0.866 (0.859–0.872)	0.042 (0.033–0.054)	0.999 (0.998–1.000)	0.843 (0.812–0.874)	0.897 (0.848–0.934)	0.413 (0.407–0.418)	0.009 (0.008–0.011)	0.998 (0.998–0.999)
Hypokalemia
DLM using 12‐lead ECG	0.866 (0.854–0.878)	0.893 (0.858–0.922)	0.704 (0.695–0.713)	0.100 (0.091–0.111)	0.994 (0.992–0.996)	0.857 (0.846–0.867)	0.896 (0.882–0.908)	0.560 (0.554–0.565)	0.120 (0.115–0.125)	0.988 (0.986–0.989)
DLM using 6‐lead ECG	0.866 (0.854–0.877)	0.896 (0.861–0.924)	0.647 (0.638–0.656)	0.086 (0.077–0.095)	0.994 (0.992–0.996)	0.831 (0.819–0.843)	0.914 (0.901–0.925)	0.435 (0.430–0.440)	0.098 (0.094–0.102)	0.987 (0.985–0.989)
DLM using 1‐lead ECG	0.797 (0.782–0.811)	0.930 (0.899–0.953)	0.465 (0.455–0.475)	0.060 (0.054–0.067)	0.994 (0.992–0.996)	0.792 (0.779–0.804)	0.888 (0.874–0.901)	0.437 (0.432–0.443)	0.096 (0.092–0.100)	0.983 (0.981–0.985)
Hypernatremia
DLM using 12‐lead ECG	0.944 (0.895–0.993)	0.923 (0.640–0.998)	0.634 (0.625–0.643)	0.003 (0.002–0.005)	1.000 (0.999–1.000)	0.839 (0.727–0.951)	0.870 (0.751–0.946)	0.649 (0.644–0.654)	0.004 (0.003–0.005)	1.000 (0.999–1.000)
DLM using 6‐lead ECG	0.903 (0.807–0.999)	0.923 (0.640–0.998)	0.488 (0.478–0.497)	0.002 (0.001–0.004)	1.000 (0.999–1.000)	0.833 (0.738–0.928)	0.889 (0.774–0.958)	0.456 (0.451–0.461)	0.003 (0.002–0.003)	1.000 (0.999–1.000)
DLM using 1‐lead ECG	0.895 (0.816–0.973)	0.846 (0.546–0.981)	0.347 (0.338–0.357)	0.002 (0.001–0.003)	0.999 (0.998–1.000)	0.806 (0.690–0.923)	0.907 (0.797–0.969)	0.253 (0.249–0.258)	0.002 (0.001–0.002)	0.999 (0.999–1.000)
Hyponatremia
DLM using 12‐lead ECG	0.885 (0.869–0.900)	0.901 (0.821–0.954)	0.820 (0.812–0.827)	0.041 (0.033–0.051)	0.999 (0.998–1.000)	0.856 (0.831–0.880)	0.887 (0.845–0.921)	0.629 (0.624–0.634)	0.020 (0.017–0.022)	0.998 (0.998–0.999)
DLM using 6‐lead ECG	0.869 (0.852–0.885)	0.890 (0.807–0.946)	0.797 (0.789–0.805)	0.036 (0.029–0.045)	0.999 (0.998–0.999)	0.851 (0.825–0.876)	0.887 (0.845–0.921)	0.599 (0.594–0.604)	0.018 (0.016–0.021)	0.998 (0.998–0.999)
DLM using 1‐lead ECG	0.834 (0.814–0.853)	0.912 (0.834–0.961)	0.686 (0.677–0.694)	0.024 (0.019–0.030)	0.999 (0.998–1.000)	0.839 (0.813–0.864)	0.915 (0.877–0.944)	0.477 (0.472–0.483)	0.015 (0.013–0.016)	0.998 (0.998–0.999)
Hypercalcemia
DLM using 12‐lead ECG	0.905 (0.806–1.000)	0.909 (0.708–0.989)	0.521 (0.511–0.530)	0.004 (0.002–0.006)	1.000 (0.999–1.000)	0.831 (0.723–0.939)	0.852 (0.738–0.930)	0.794 (0.790–0.798)	0.007 (0.005–0.009)	1.000 (0.999–1.000)
DLM using 6‐lead ECG	0.878 (0.791–0.966)	0.864 (0.651–0.971)	0.605 (0.596–0.615)	0.004 (0.003–0.007)	1.000 (0.999–1.000)	0.813 (0.726–0.900)	0.885 (0.778–0.953)	0.690 (0.685–0.695)	0.005 (0.004–0.006)	1.000 (0.999–1.000)
DLM using 1‐lead ECG	0.875 (0.786–0.965)	0.909 (0.708–0.989)	0.352 (0.343–0.361)	0.003 (0.002–0.004)	0.999 (0.998–1.000)	0.634 (0.522–0.746)	0.918 (0.819–0.973)	0.592 (0.587–0.597)	0.004 (0.003–0.005)	1.000 (0.999–1.000)
Hypocalcemia
DLM using 12‐lead ECG	0.901 (0.880–0.922)	0.891 (0.809–0.947)	0.847 (0.84–0.854)	0.048 (0.038–0.059)	0.999 (0.998–0.999)	0.813 (0.793–0.834)	0.905 (0.877–0.929)	0.551 (0.546–0.557)	0.031 (0.028–0.033)	0.997 (0.996–0.998)
DLM using 6‐lead ECG	0.876 (0.858–0.894)	0.902 (0.822–0.954)	0.777 (0.769–0.785)	0.034 (0.027–0.042)	0.999 (0.998–1.000)	0.812 (0.792–0.833)	0.928 (0.902–0.948)	0.473 (0.467–0.478)	0.027 (0.024–0.029)	0.998 (0.997–0.998)
DLM using 1‐lead ECG	0.860 (0.839–0.882)	0.913 (0.836–0.962)	0.752 (0.744–0.760)	0.031 (0.025–0.038)	0.999 (0.998–1.000)	0.798 (0.777–0.819)	0.883 (0.853–0.909)	0.547 (0.541–0.552)	0.030 (0.027–0.032)	0.997 (0.996–0.997)