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Critical care providers and EEG experts showed similar seizure identification performance using quantitative EEG tools after training. These tools show promise for bedside seizure screening by critical care teams.

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Area of Science:

  • Neuroscience
  • Medical Technology
  • Critical Care Medicine

Background:

  • Seizure detection in intensive care units (ICUs) is crucial for patient management.
  • Quantitative electroencephalography (qEEG) display tools offer potential for improved seizure identification.
  • Comparing the diagnostic accuracy of critical care providers and electroencephalography (EEG) experts using these tools is essential.

Purpose of the Study:

  • To compare the performance of critical care providers (ICU fellows, ICU nurses) with EEG experts (neurophysiologists, EEG technologists) in identifying seizures.
  • To evaluate the effectiveness of amplitude-integrated electroencephalography (aEEG) and color density spectral array (CDSA) displays for seizure detection.

Main Methods:

  • A diagnostic accuracy comparison study was conducted at a Canadian quaternary children's hospital.
  • Participants received standardized training on aEEG and CDSA displays.
  • Trained participants reviewed 27 continuous EEG recordings (487 hours total) containing 553 seizures.

Main Results:

  • Seizure identification sensitivity using aEEG was comparable between ICU fellows (83.8%), ICU nurses (73.1%), and neurophysiologists (81.5%), but lower for EEG technologists (66.7%).
  • Sensitivity using CDSA was comparable across all groups: ICU fellows (82.4%), ICU nurses (88.2%), neurophysiologists (83.3%), and EEG technologists (73.3%).
  • False-positive rates were comparable across groups for both display types, and professional background influenced performance more than individual skill.

Conclusions:

  • After standardized training, critical care providers demonstrated performance comparable to EEG experts in identifying seizures using aEEG and CDSA displays.
  • Quantitative EEG tools show potential for bedside seizure screening by critical care providers.
  • Further validation in real-world ICU settings is needed to confirm these promising findings.