Abstract
The electroencephalography (EEG) signal has a high complexity, and the process of extracting clinically relevant features is achieved by visual analysis of the recordings. The interobserver agreement in EEG interpretation is only moderate. This is partly due to the method of reporting the findings in free-text format. The purpose of our endeavor was to create a computer-based system for EEG assessment and reporting, where the physicians would construct the reports by choosing from predefined elements for each relevant EEG feature, as well as the clinical phenomena (for video-EEG recordings). A working group of EEG experts took part in consensus workshops in Dianalund, Denmark, in 2010 and 2011. The faculty was approved by the Commission on European Affairs of the International League Against Epilepsy (ILAE). The working group produced a consensus proposal that went through a pan-European review process, organized by the European Chapter of the International Federation of Clinical Neurophysiology. The Standardised Computer-based Organised Reporting of EEG (SCORE) software was constructed based on the terms and features of the consensus statement and it was tested in the clinical practice. The main elements of SCORE are the following: personal data of the patient, referral data, recording conditions, modulators, background activity, drowsiness and sleep, interictal findings, “episodes” (clinical or subclinical events), physiologic patterns, patterns of uncertain significance, artifacts, polygraphic channels, and diagnostic significance. The following specific aspects of the neonatal EEGs are scored: alertness, temporal organization, and spatial organization. For each EEG finding, relevant features are scored using predefined terms. Definitions are provided for all EEG terms and features. SCORE can potentially improve the quality of EEG assessment and reporting; it will help incorporate the results of computer-assisted analysis into the report, it will make possible the build-up of a multinational database, and it will help in training young neurophysiologists.
Highlights
Background activityBackground activity contains three main subchapters: posterior dominant rhythm, other organized rhythms, and special features
The faculty of the workshop was approved by the Commission on European Affairs (CEA) of the International League Against Epilepsy (ILAE), and the event was advertised on the homepage of the European Epilepsy Academy, the education and research organization of the CEA-ILAE
The Standardised Computerbased Organised Reporting of EEG (SCORE) working group, consisting of 25 clinical neurophysiologists/epileptologists from 15 European countries, elaborated a consensus proposal meant to reflect the needs and practice in different countries/centers. This consensus proposal was subsequently submitted to a pan-European review, organized by the European Chapter of the International Federation of Clinical Neurophysiology (IFCN)
Summary
Background activity contains three main subchapters: posterior dominant rhythm, other organized rhythms, and special features. The definition of the terms is detailed in Appendix S2. For each recording the posterior dominant activity only can be scored only once. The electroencephalographer can score here the global interpretation of the posterior dominant activity for the patient (taking into account the age and the state of consciousness). The following choices are available: normal, abnormal, no definite abnormality, not possible to determine. To speed up scoring of most recordings, a short-key redirects the flowchart to the window where frequency of the posterior dominant rhythm can be specified
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