Electroencephalography Technologist Inter-rater Agreement and Interpretation of Pediatric Critical Care Electroencephalography - 18/01/21
, Jaime D. Twanow, MD a, Jorge Vidaurre, MD a, Satyanarayana Gedela, MD, MRCP(UK) b, Melissa Moore-Clingenpeel, MA, MAS c, Adam P. Ostendorf, MD aAbstract |
Objectives |
Electroencephalography (EEG) technologists commonly screen continuous EEG. Until now, the inter-rater agreement or sensitivity for important EEG findings has been unknown in this group.
Methods |
Twenty-nine EEG technologists and three clinical neurophysiologists interpreted 90 five-minute samples of pediatric critical care EEG. Inter-rater agreement was examined with Cohen’s kappa and Fleiss’ kappa for EEG findings. A gold-standard consensus agreement was developed for examining sensitivity and specificity for seizures or discontinuity. Kruskal-Wallis tests with Benjamani-Hochberg corrections for multiple comparisons were utilized to examine associations between correct scoring and certification status and years of experience.
Results |
Aggregate agreement was moderate for seizures and fair for EEG background continuity among EEG technologists. Individual agreement for seizures and continuity varied from slight to substantial. For individual EEG technologists, sensitivity for seizures ranged from 44 to 93% and sensitivity for continuity ranged from 81 to 100%. Raters with Certified Long Term Monitoring credentials were more likely to identify seizures correctly.
Significance |
This is the first study to evaluate inter-rater agreement and interpretation correctness among EEG technologists interpreting pediatric critical care EEG. EEG technologists demonstrated better aggregate agreement for seizure detection than other EEG findings, yet individual results and internal consistency varied widely. These data provide important insight into the common practice of utilizing EEG technologists for screening critical care EEG.
Le texte complet de cet article est disponible en PDF.Keywords : Seizure, Intensive care, Continuous EEG monitoring, Kappa, EEG technologists
Plan
| Conflict of interest: none. |
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| Statistical Analysis: conducted by Melissa Moore-Clingenpeel, Nationwide Children’s Hospital. |
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| Funding: The project described was supported by Award Number UL1RR025755 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. |
Vol 115
P. 66-71 - février 2021 Retour au numéro
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