Nicholas S Abend1, Shavonne L Massey, Mark Fitzgerald, France Fung, Natalie J Atkin, Rui Xiao, Alexis A Topjian. 1. Departments of *Neurology, †Pediatrics, and ‡Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.; and §Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania, U.S.A.
Abstract
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category. RESULTS: The overall background category (normal, slow-disorganized, discontinuous, or attenuated-featureless) had almost perfect agreement (kappa 0.89).The ACNS Standardized Critical Care EEG variables had agreement that was (1) almost perfect for the seizures variable (kappa 0.93), (2) substantial for the continuity (kappa 0.79), voltage (kappa 0.70), and sleep transient (kappa 0.65) variables, (3) moderate for the rhythmic or periodic patterns (kappa 0.55) and interictal epileptiform discharge (kappa 0.60) variables, and (4) fair for the predominant frequency (kappa 0.23) and symmetry (kappa 0.31) variables. Condensing variable options led to improved agreement for the continuity and voltage variables. CONCLUSIONS: These data support the use of the standardized terminology and the composite overall background category as a basis for standardized EEG interpretation for subsequent studies assessing EEG background for neuroprognostication after pediatric cardiac arrest.
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category. RESULTS: The overall background category (normal, slow-disorganized, discontinuous, or attenuated-featureless) had almost perfect agreement (kappa 0.89).The ACNS Standardized Critical Care EEG variables had agreement that was (1) almost perfect for the seizures variable (kappa 0.93), (2) substantial for the continuity (kappa 0.79), voltage (kappa 0.70), and sleep transient (kappa 0.65) variables, (3) moderate for the rhythmic or periodic patterns (kappa 0.55) and interictal epileptiform discharge (kappa 0.60) variables, and (4) fair for the predominant frequency (kappa 0.23) and symmetry (kappa 0.31) variables. Condensing variable options led to improved agreement for the continuity and voltage variables. CONCLUSIONS: These data support the use of the standardized terminology and the composite overall background category as a basis for standardized EEG interpretation for subsequent studies assessing EEG background for neuroprognostication after pediatric cardiac arrest.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Rebecca M Starling; Karuna Shekdar; Dan Licht; Vinay M Nadkarni; Robert A Berg; Alexis A Topjian Journal: Pediatr Crit Care Med Date: 2015-07 Impact factor: 3.624
Authors: Alexis A Topjian; Benjamin French; Robert M Sutton; Thomas Conlon; Vinay M Nadkarni; Frank W Moler; J Michael Dean; Robert A Berg Journal: Crit Care Med Date: 2014-06 Impact factor: 7.598
Authors: Alexis A Topjian; Sarah M Sánchez; Justine Shults; Robert A Berg; Dennis J Dlugos; Nicholas S Abend Journal: Pediatr Crit Care Med Date: 2016-06 Impact factor: 3.624
Authors: N S Abend; A Topjian; R Ichord; S T Herman; M Helfaer; M Donnelly; V Nadkarni; D J Dlugos; R R Clancy Journal: Neurology Date: 2009-06-02 Impact factor: 9.910
Authors: Nicolas Gaspard; Lawrence J Hirsch; Suzette M LaRoche; Cecil D Hahn; M Brandon Westover Journal: Epilepsia Date: 2014-06-02 Impact factor: 5.864
Authors: Lennart van Zellem; Corinne Buysse; Marlous Madderom; Jeroen S Legerstee; Femke Aarsen; Dick Tibboel; Elisabeth M Utens Journal: Intensive Care Med Date: 2015-04-18 Impact factor: 17.440
Authors: Seungha Lee; Xuelong Zhao; Kathryn A Davis; Alexis A Topjian; Brian Litt; Nicholas S Abend Journal: Neurology Date: 2019-04-10 Impact factor: 9.910
Authors: Nicholas S Abend; Douglas J Wiebe; Rui Xiao; Shavonne L Massey; Mark Fitzgerald; France Fung; Alexis A Topjian Journal: J Clin Neurophysiol Date: 2018-05 Impact factor: 2.177
Authors: Henry H Cheng; Satish K Rajagopal; Arnold J Sansevere; Erica McDavitt; Daniel Wigmore; Jessica Mecklosky; Kristofer Andren; Kathryn A Williams; Amy Danehy; Janet S Soul Journal: Resuscitation Date: 2018-02-21 Impact factor: 5.262
Authors: France W Fung; Zi Wang; Darshana S Parikh; Marin Jacobwitz; Lisa Vala; Maureen Donnelly; Alexis A Topjian; Rui Xiao; Nicholas S Abend Journal: Neurology Date: 2021-04-23 Impact factor: 11.800
Authors: Alexis A Topjian; Bingqing Zhang; Rui Xiao; France W Fung; Robert A Berg; Kathryn Graham; Nicholas S Abend Journal: Resuscitation Date: 2021-07-05 Impact factor: 6.251