The reliability of visual scoring of alpha EEG activity during sleep

The reliability of visual scoring of alpha electroencephalogram activity in nonrapid eye movement sleep was evaluated. Three trained scorers independently, on two occasions, assessed one record from each of 10 patients. In addition to standard sleep staging of the records, alpha activity was scored using three methods: a) while the record was being scored, an assessment of alpha activity during the preceding stage was made at each stage change; b) after the record was scored a single global rating of alpha was made; and c) each 20-second epoch of the record was rated on the amount of alpha present. Relative and absolute generalizability coefficients in excess of 0.810 and 0.698, respectively, were obtained. However, the results also indicated that careful attention to methodological factors is critical in ensuring satisfactory standards of reliability.