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Diagnostic Accuracy of Electrographic Seizure Detection by Neurophysiologists and Non-Neurophysiologists in the Adult ICU Using a Panel of Quantitative EEG Trends.

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Date
2015-08
Authors
Swisher, Christa B
White, Corey R
Mace, Brian E
Dombrowski, Keith E
Husain, Aatif M
Kolls, Bradley J
Radtke, Rodney R
Tran, Tung T
Sinha, Saurabh R
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(9 total)
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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 article
Subject
Adult
Aged
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
Permalink
https://hdl.handle.net/10161/13724
Published Version (Please cite this version)
10.1097/WNP.0000000000000144
Publication 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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Scholars@Duke

Dombrowski

Keith Dombrowski

Assistant Professor of Neurology
Husain

Aatif Mairaj Husain

Professor of Neurology
Kolls

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
Sinha

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.
Swisher

Christa Brittany Swisher

Assistant Professor of Neurology
Tran

Tung T Tran

Assistant Professor of Neurology
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