Diagnostic Accuracy of Electrographic Seizure Detection by Neurophysiologists and Non-Neurophysiologists in the Adult ICU Using a Panel of Quantitative EEG Trends.
Abstract
PURPOSE: To evaluate the sensitivity and specificity of a panel of quantitative EEG
(qEEG) trends for seizure detection in adult intensive care unit (ICU) patients when
reviewed by neurophysiologists and non-neurophysiologists. METHODS: One hour qEEG
panels (n = 180) were collected retrospectively from 45 ICU patients and were distributed
to 5 neurophysiologists, 7 EEG technologists, and 5 Neuroscience ICU nurses for evaluation
of seizures. Each panel consisted of the following qEEG tools, displayed separately
for left and right hemisphere electrodes: rhythmicity spectrogram (rhythmic run detection
and display; Persyst Inc), color density spectral array, EEG asymmetry index, and
amplitude integrated EEG. The reviewers did not have access to the raw EEG data. RESULTS:
For the reviewer's ability to detect the presence of seizures on qEEG panels when
compared with the gold standard of independent raw EEG review, the sensitivities and
specificities are as follows: neurophysiologists 0.87 and 0.61, EEG technologists
0.80 and 0.80, and Neuroscience ICU nurses 0.87 and 0.61, respectively. There was
no statistical difference among the three groups regarding sensitivity. CONCLUSIONS:
Quantitative EEG display panels are a promising tool to aid detection of seizures
by non-neurophysiologists as well as by neurophysiologists. However, even when used
as a panel, qEEG trends do not appear to be adequate as the sole method for reviewing
continuous EEG data.
Type
Journal articleSubject
AdultAged
Aged, 80 and over
Electroencephalography
Female
Humans
Intensive Care Units
Male
Middle Aged
Neurophysiology
Retrospective Studies
Seizures
Sensitivity and Specificity
Spectrum Analysis
Time Factors
Young Adult
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https://hdl.handle.net/10161/13724Published Version (Please cite this version)
10.1097/WNP.0000000000000144Publication Info
Swisher, Christa B; White, Corey R; Mace, Brian E; Dombrowski, Keith E; Husain, Aatif
M; Kolls, Bradley J; ... Sinha, Saurabh R (2015). Diagnostic Accuracy of Electrographic Seizure Detection by Neurophysiologists and
Non-Neurophysiologists in the Adult ICU Using a Panel of Quantitative EEG Trends.
J Clin Neurophysiol, 32(4). pp. 324-330. 10.1097/WNP.0000000000000144. Retrieved from https://hdl.handle.net/10161/13724.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Keith Dombrowski
Assistant Professor of Neurology
Aatif Mairaj Husain
Professor of Neurology
Bradley Jason Kolls
Associate Professor of Neurology
As a neurointensivist, I am interested in improving our ability to monitor brain function
and impact of therapy on our patients in the critical care setting. To this end I
am developing new approaches to patient monitoring that will integrate patient physiologic
monitoring with brain activity recorded by electroencephalography (EEG). On the basic
science side I am interested in the central nervous system's response to injury. Although
much attention has been focused on closed head injury as
Saurabh Ranjan Sinha
Associate Professor of Neurology
My research and clinical interests are in improving surgical outcomes for patients
with intractable seizures and normal imaging studies (non-lesional epilepsy). I also
have a research interest in ICU EEG monitoring with emphasis on quantitative EEG
and seizure burden.
Christa Brittany Swisher
Assistant Professor of Neurology
Tung T Tran
Assistant Professor of Neurology
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