Abstract
ObjectiveInterpretation of the EEG background pattern in routine recordings is an important part of clinical reviews. We evaluated the feasibility of an automated analysis system to assist reviewers with evaluation of the general properties in the EEG background pattern.MethodsQuantitative EEG methods were used to describe the following five background properties: posterior dominant rhythm frequency and reactivity, anterior-posterior gradients, presence of diffuse slow-wave activity and asymmetry. Software running the quantitative methods were given to ten experienced electroencephalographers together with 45 routine EEG recordings and computer-generated reports. Participants were asked to review the EEGs by visual analysis first, and afterwards to compare their findings with the generated reports and correct mistakes made by the system. Corrected reports were returned for comparison.ResultsUsing a gold-standard derived from the consensus of reviewers, inter-rater agreement was calculated for all reviewers and for automated interpretation. Automated interpretation together with most participants showed high (kappa > 0.6) agreement with the gold standard. In some cases, automated analysis showed higher agreement with the gold standard than participants. When asked in a questionnaire after the study, all participants considered computer-assisted interpretation to be useful for every day use in routine reviews.ConclusionsAutomated interpretation methods proved to be accurate and were considered to be useful by all participants.SignificanceComputer-assisted interpretation of the EEG background pattern can bring consistency to reviewing and improve efficiency and inter-rater agreement.
Highlights
Scalp EEG is used in a wide range of clinical settings to obtain a non-invasive measurement of cortical brain activity
The recordings are typically analyzed by visual inspection of the signals in their raw form, and apart from being a time consuming and error prone task which may lead to missed events, this can result in high inter- and intra-rater variability depending on the level of experience and degree of concentration of the reviewer [1]
For routine outpatient recordings this plays an important part in epilepsy diagnostics [2,3], clinical psychiatry [4] and the diagnosis of neurodegenerative diseases [5,6,7]
Summary
Scalp EEG is used in a wide range of clinical settings to obtain a non-invasive measurement of cortical brain activity. Having a higher temporal resolution and being more affordable, portable and widely available than fMRI and MEG, its uses range from diagnostics and monitoring for outpatient recordings, to continuous monitoring in the ICU. An important part of EEG reviews is the analysis of the background pattern. Continuous monitoring of the background pattern in the ICU can alert medical staff of sudden changes that require immediate intervention [8,9,10], thereby changing its role from passive to an active tool for improving the outcomes of the critically ill
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