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Quantitative analysis of EEG reactivity for neurological prognostication after cardiac arrest
M M Admiraal1, L A Ramos2, S Delgado Olabarriaga3
1Amsterdam UMC, University of Amsterdam, Department of Neurology/Clinical Neurophysiology, Amsterdam Neuroscience, Amsterdam, the Netherlands.
Objective:
To test whether 1) quantitative analysis of EEG reactivity (EEG-R) using machine learning (ML) is superior to visual analysis, and 2) combining quantitative analyses of EEG-R and EEG background pattern increases prognostic value for prediction of poor outcome after cardiac arrest (CA).
Methods:
Several types of ML models were trained with twelve quantitative features derived from EEG-R and EEG background data of 134 adult CA patients. Poor outcome was a Cerebral Performance Category score of 3-5 within 6 months.
Results:
The Random Forest (RF) trained on EEG-R showed the highest AUC of 83% (95-CI 80-86) of tested ML classifiers, predicting poor outcome with 46% sensitivity (95%-CI 40-51) and 89% specificity (95%-CI 86-92). Visual analysis of EEG-R had 80% sensitivity and 65% specificity. The RF was also the best classifier for EEG background (AUC 85%, 95%-CI 83-88) at 24 h after CA, with 62% sensitivity (95%-CI 57-67) and 84% specificity (95%-CI 79-88). Combining EEG-R and EEG background RF classifiers reduced the number of false positives.
Conclusions:
Quantitative EEG-R using ML predicts poor outcome with higher specificity, but lower sensitivity compared to visual analysis of EEG-R, and is of some additional value to ML on EEG background data.
Significance:
Quantitative EEG-R using ML is a promising alternative to visual analysis and of some added value to ML on EEG background data.
