The Megacare Electrocardiographic (ECG) Management System (Siemens-Elema, Stockholm, Sweden) incorporates methods for serial comparison of the 12-lead ECG based on the Glasgow interpretation program. While a computer is obviously useful for reporting serial changes following myocardial infarction, it was believed helpful to produce a summary serial comparison statement that would take into account the fact that ECG appearances may normally fluctuate from day to day for a variety of reasons. Thus, five additional summary statements were added to the Glasgow program to indicate the extent of change globally compared to the previous ECG recording. In an ECG management system, an important facility that can potentially cause difficulties with serial comparison is overreading. When a statement has been altered by a reviewer, the changes are required to be incorporated into the ECG file so that in any subsequent serial comparison, the modified report is available for comparison with the next ECG. The Megacare system allows for this, and its methodology is described in this article.
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