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Keywords = digital ECG data interchange protocol

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26 pages, 3457 KiB  
Review
The History and Challenges of SCP-ECG: The Standard Communication Protocol for Computer-Assisted Electrocardiography
by Paul Rubel, Jocelyne Fayn, Peter W. Macfarlane, Danilo Pani, Alois Schlögl and Alpo Värri
Hearts 2021, 2(3), 384-409; https://doi.org/10.3390/hearts2030031 - 24 Aug 2021
Cited by 9 | Viewed by 6784
Abstract
Ever since the first publication of the standard communication protocol for computer-assisted electrocardiography (SCP-ECG), prENV 1064, in 1993, by the European Committee for Standardization (CEN), SCP-ECG has become a leading example in health informatics, enabling open, secure, and well-documented digital data exchange at [...] Read more.
Ever since the first publication of the standard communication protocol for computer-assisted electrocardiography (SCP-ECG), prENV 1064, in 1993, by the European Committee for Standardization (CEN), SCP-ECG has become a leading example in health informatics, enabling open, secure, and well-documented digital data exchange at a low cost, for quick and efficient cardiovascular disease detection and management. Based on the experiences gained, since the 1970s, in computerized electrocardiology, and on the results achieved by the pioneering, international cooperative research on common standards for quantitative electrocardiography (CSE), SCP-ECG was designed, from the beginning, to empower personalized medicine, thanks to serial ECG analysis. The fundamental concept behind SCP-ECG is to convey the necessary information for ECG re-analysis, serial comparison, and interpretation, and to structure the ECG data and metadata in sections that are mostly optional in order to fit all use cases. SCP-ECG is open to the storage of the ECG signal and ECG measurement data, whatever the ECG recording modality or computation method, and can store the over-reading trails and ECG annotations, as well as any computerized or medical interpretation reports. Only the encoding syntax and the semantics of the ECG descriptors and of the diagnosis codes are standardized. We present all of the landmarks in the development and publication of SCP-ECG, from the early 1990s to the 2009 International Organization for Standardization (ISO) SCP-ECG standards, including the latest version published by CEN in 2020, which now encompasses rest and stress ECGs, Holter recordings, and protocol-based trials. Full article
(This article belongs to the Special Issue The Application of Computer Techniques to ECG Interpretation)
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Figure 1

Figure 1
<p>Example of the high compression obtained by subtracting a reference beat from all complexes (including extrasystoles), filtering and sample decimation of the non-protected areas, and second difference calculations [<a href="#B42-hearts-02-00031" class="html-bibr">42</a>]. These types of lossy compression schemes, e.g., filtering, sample decimation, and beat subtraction, are no longer allowed in SCP-ECG V3.0 (See Chapter 4 and [<a href="#B39-hearts-02-00031" class="html-bibr">39</a>]). Figure adapted from EN 1064:2020 [<a href="#B39-hearts-02-00031" class="html-bibr">39</a>].</p>
Full article ">Figure 2
<p>Snapshot of the conceptual ECG data acquisition reference model developed during the AIM A1015 SCP-ECG project and fully implemented during the OEDIPE project [<a href="#B40-hearts-02-00031" class="html-bibr">40</a>,<a href="#B43-hearts-02-00031" class="html-bibr">43</a>,<a href="#B48-hearts-02-00031" class="html-bibr">48</a>,<a href="#B49-hearts-02-00031" class="html-bibr">49</a>,<a href="#B50-hearts-02-00031" class="html-bibr">50</a>,<a href="#B51-hearts-02-00031" class="html-bibr">51</a>].</p>
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<p>Generic bi-directional SCP-ECG message to database interface schema. This is an updated version of the original “File to Database” schema developed by the OEDIPE project [<a href="#B49-hearts-02-00031" class="html-bibr">49</a>], where eXtensible Markup Language (XML) and eXtensible Stylesheet Language Transformations (XSLT) tools were based on Abstract Syntax Notation 1 (ASN.1) [<a href="#B50-hearts-02-00031" class="html-bibr">50</a>,<a href="#B51-hearts-02-00031" class="html-bibr">51</a>]. The interface updates the database with electrocardiographic information coming from the messages and gives the message handler data retrieved from the database. The solution contains generic software modules independent of the database and SCP-ECG protocol layout. It accesses a descriptive data dictionary containing the database structure, the data format layout, and the mapping between both. The design involves issues related to structure description and standard query language generation and allows automating the development of SCP-ECG Vx.i to Vy.j converters. For more details, see [<a href="#B50-hearts-02-00031" class="html-bibr">50</a>,<a href="#B62-hearts-02-00031" class="html-bibr">62</a>,<a href="#B63-hearts-02-00031" class="html-bibr">63</a>].</p>
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<p>Snapshot of the data part of Section 7 (global measurements), highlighting the structure of the additional global measurements data block and of one of the optional tagged fields, e.g., Tag 8, “QRS Maximum Vector Magnitudes”. SCP-ECG V3.0 defines 17 tagged global ECG measurement data fields, numbered from 0 to 16. The structure and content of tag 8 are detailed in the bottom left (tag, length, value) table. The number of tagged fields actually stored may vary from one SCP-ECG record to another.</p>
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