在线客服: 点击这里给我发消息  新用户使用步骤:会员注册→充值→重新登入→进入资源
标题:Improving the inter-rater agreement of hypsarrhythmia using a simplified EEG grading scale for children with infantile spasms.
时间:2019-11-19 23:10:42
DOI:10.1016/j.eplepsyres.2015.07.008
PMID:26280806
关键词:К, Fleiss’ kappa;BASED, Burden of Amplitudes and Epileptiform Discharges;Infantile spasms;West syndrome;Electroencephalogram;EEG;Epileptic encephalopathy;BASED score;
出版源: Epilepsy Research ,116 :S0920121115300309
摘要:Highlights • We confirm hypsarrhythmia's poor inter-rater agreement among blinded reviewers. • The inter-rater agreement of hypsarrhythmia can be improved using the BASED score. • The BASED score is a simplified EEG grading scale for infantile spasms patients. • The BASED score allows for the accurate interpretation of electrographic outcome. • The BASED score appears to be a reliable, accurate and feasible EEG grading scale. Abstract Background There is poor inter-rater agreement in determining the presence or absence of hypsarrhythmia among patients with infantile spasms. Yet, remission of hypsarrhythmia has been used as a clinical and research outcome measure. Two important features of hypsarrhythmia are the burden of epileptiform discharges and the amplitudes of background slow waves. We hypothesized that an electroencephalogram (EEG) grading scale emphasizing epileptiform discharge burden and the amplitudes of background slow waves would improve inter-rater agreement in interpreting hypsarrhythmia. Our aim was to assess inter-rater agreement of hypsarrhythmia using a novel and simplified EEG grading scale called the ‘BASED’ (Burden of Amplitudes and Epileptiform Discharges) score and compare this to the traditional method of EEG analysis. Methods Twenty patients with infantile spasms were prospectively evaluated and electroclinical outcomes were determined. Forty EEG clips (20 pre-treatment and 20 post-treatment), representing the most severely abnormal five minute sleep epoch of each study, were assessed by three reviewers blinded to treatment and clinical outcome. Fleiss’ kappa (К) was used to assess the inter-rater agreement in the interpretation of hypsarrhythmia when using the BASED score compared to the traditional method of EEG analysis. Results Reviewers had favorable inter-rater agreement using the BASED score in interpreting hypsarrhythmia (К: 0.87) compared to when using the traditional method of EEG analysis to interpret hypsarrhythmia (К: 0.09). The three reviewers all agreed on the presence or absence of hypsarrhythmia in 37/40 (93%) epochs using the BASED score but in only 15/40 (38%) epochs using the traditional method of EEG analysis, p = <0.001. Conclusion When compared to the traditional method of EEG analysis, the BASED score allowed for better inter-rater agreement in the interpretation of hypsarrhythmia. Future infantile spasms clinical trials must better define criteria for hypsarrhythmia.
大小:1608 kb
下载: 点击下载
预览:

浏览器不支持嵌入PDF阅读,打开新页面在线阅读

目录:
  • Improving the inter-rater agreement of hypsarrhythmia using a simplified EEG grading scale for children with infantile spasms
    • 1 Introduction
    • 2 Materials and methods
      • 2.1 Patient recruitment
      • 2.2 EEG Selection
      • 2.3 Definition of electroclinical remission
      • 2.4 EEG analysis and use of the BASED score
      • 2.5 The scoring document
      • 2.6 Outcome definitions
      • 2.7 Statistical analysis
      • 2.8 Ethics
    • 3 Results
      • 3.1 Selected EEG patient characteristics
      • 3.2 Illustration of the BASED score
      • 3.3 Comparison summary table
      • 3.4 Inter-rater agreement (BASED score versus traditional method of EEG analysis)
      • 3.5 Inter-rater reliability on BASED score coding
      • 3.6 Sensitivity and specificity of a pre-determined cutoff BASED score for the presence or absence of hypsarrhythmia
      • 3.7 Rater accuracy and complete agreement in the interpretation of electrographic outcome (BASED score versus traditional ...
    • 4 Discussion
      • 4.1 Conclusions
    • 5 Funding
    • Acknowledgements
    • Appendix A Supplementary data
    • References
    • Web-based reference

本页内容由网络收集而来,版权归原创者所有,如有侵权请及时联系