Minnesota ECG Coding
For over 40 years, Minnesota ECG Coding has been a major electrocardiographic computer and visual reading service for epidemiological studies and clinical trials nationally and internationally.
The mission of the center was to document the prognostic and diagnostic value of electrocardiography for epidemiological studies and clinical trials. The Coding Center was at the fore front of developing and evaluating new criteria sets for incident cardiac events including silent myocardial infarction, ischemia, left ventricular hypertrophy, QT dispersion, and heart rate variability.
Dr. Crow has enlarged the Minnesota Code classsification procedures to include standardized serial ECG comparision to document incident or recurrent (silent) myocardial infarction, in-hospital Q wave myocardial infarction, progression or regression of LVH (See studies MRFIT, TOMHS and ALLHAT), and ECG quality control methodology.
Dr. Ronald Prineas has served as director of the Minnesota Central ECG Laboratory and Miami ECG Coding Center in the past.
He has 34 years of experience in the design, conduct and implementation of multicenter studies (epidemiologic and clinical) that make use of the ECG. He is also a consultant to the World Health Organization (WHO) on population electrocardiography.
Dr. Henry Blackburn is the founding father of The Minnesota Code. He developed the original standardized criteria in the late 1950s, to meet the needs for objective comparisions of heart disease rates amongst countries.
In 1968, Dr. Blackburn and Geoffrey Rose of London first published the Minnesota Code with the World Health Organization in a book entitled, Cardiovascular Survey Methods. Dr. Blackburn is also responsible for developing the idea of training technicians to code ECG’s in the laboratory setting. (See History of ECG Coding.)
For more than 40 years, the Minnesota ECG Coding Center has been the major electrocardiographic visual reading service center for epidemiological studies and clinical trials, both nationally and internationally. The mission of the Center is to document the prognostic and diagnostic value of electrocardiography for epidemiological studies and clinical trials. The Center has been at the forefront of developing and evaluating new criteria sets for incident cardiac events, including silent or symptomatic myocardial infarction, ischemia, left ventricular hypertrophy, QT dispersion, and heart rate variability.
The Minnesota Code is a classification system for the electrocardiogram that utilizes a defined set of measurement rules to assign specific numerical codes according to severity of ECG findings. The Minnesota Code, developed in the late 1950s by Dr. Henry Blackburn in response to the need for reporting ECG findings in uniform, clearly defined, and objective terms, is the most widely used ECG classification system in the world for clinical trials and epidemiologic studies. It incorporates ECG classification criteria that have been validated, widely employed, and accepted by clinicians. The Minnesota Code provides an objective ECG classification system free of impressionist physician bias, by which different studies can have a common standard to compare or pool ECG findings. It now includes objective procedures for defining significant pattern changes from serial ECG comparison, such as evidence of new MI, new ischemia, progression or regression of LVH and new conduction defect.
Minnesota Code procedures have been incorporated into a computer program, the Minnesota Code Modular ECG Analysis System (MC-MEANS). MC-MEANS also includes logic for serial ECG comparison, developed and validated at the Center.
EpiCH faculty, along with other researchers around the world, use these facilities for service and research activities. Active collaboration is ongoing between ECG Centers at Wake Forest University in North Carolina and Erasmus University in Rotterdam, Netherlands.
The Center provides the following services: Visual or computer assigned standard Minnesota Codes; amplitude, axis and duration measurements; serial ECG comparisons for documenting evolving Q-waves, evolving ST-T waves, evolving bundle branch block and progression or regression of ECG LVH and visual or computer determination of left ventricular mass index; prolonged heart rate corrected QT or JT intervals; heart rate variability; QT dispersion; T-wave axis; and ECG prognostic score.
The Center currently has eight active studies that send approximately 3,500 ECGs per month for analysis. The Minnesota ECG Coding Center also provides training and evaluation of technical staff for new studies and refresher training for ongoing studies. Researchers wishing to use the Minnesota Code to code their own ECGs can use the Minnesota Code interactive computer tutorial or can submit samples of their coded ECGs for evaluation