Prospective evaluation of interrater agreement between EEG technologists and neurophysiologists

  • We aim to prospectively investigate, in a large and heterogeneous population, the electroencephalogram (EEG)-reading performances of EEG technologists. A total of 8 EEG technologists and 5 certified neurophysiologists independently analyzed 20-min EEG recordings. Interrater agreement (IRA) for predefined EEG pattern identification between EEG technologists and neurophysiologits was assessed using percentage of agreement (PA) and Gwet-AC1. Among 1528 EEG recordings, the PA [95% confidence interval] and interrater agreement (IRA, AC1) values were as follows: status epilepticus (SE) and seizures, 97% [96–98%], AC1 kappa = 0.97; interictal epileptiform discharges, 78% [76–80%], AC1 = 0.63; and conclusion dichotomized as “normal” versus “pathological”, 83.6% [82–86%], AC1 = 0.71. EEG technologists identified SE and seizures with 99% [98–99%] negative predictive value, whereas the positive predictive values (PPVs) were 48% [34–62%] and 35% [20–53%], respectively. The PPV for normal EEGs was 72% [68–76%]. SE and seizure detection were impaired in poorly cooperating patients (SE and seizures; p < 0.001), intubated and older patients (SE; p < 0.001), and confirmed epilepsy patients (seizures; p = 0.004). EEG technologists identified ictal features with few false negatives but high false positives, and identified normal EEGs with good PPV. The absence of ictal features reported by EEG technologists can be reassuring; however, EEG traces should be reviewed by neurophysiologists before taking action.
Author:Isabelle Beuchat, Senubia Alloussi, Philipp Sebastian ReifGND, Nora Sterlepper, Felix RosenowORCiDGND, Adam StrzelczykORCiDGND
Parent Title (English):Scientific reports
Publisher:Macmillan Publishers Limited, part of Springer Nature
Place of publication:[London]
Document Type:Article
Date of Publication (online):2021/06/28
Date of first Publication:2021/06/28
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/06/08
Tag:Encephalopathy; Epilepsy
Issue:art. 13406
Page Number:9
First Page:1
Last Page:9
Open Access funding enabled and organized by Projekt DEAL. This study was supported by a LOEWE Grant from the State of Hessen for the “Center for Personalized Translational Epilepsy Research” (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany.
IB: reports a research grant from the Swiss National Science Foundation. SA: reports no conflict of interest. PSR: reports personal fees from Eisai. NS: reports no conflict of interest. FR: reports personal fees from Arvelle Therapeutics, Eisai, GW Pharmaceuticals, Novartis, Medtronic, and UCB, and grants from the Detlev-Wrobel-Fonds for Epilepsy Research, the Deutsche Forschungsgemeinschaft, the LOEWE Program of the State of Hesse, and the European Union. AS: reports personal fees and grants from Arvelle Therapeutics, Desitin Arzneimittel, Eisai, GW Pharmaceuticals companies, LivaNova, Marinus Pharma, Medtronic, UCB, and Zogenix.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0