Trial reportAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2014
Effect of microEEG on clinical management and outcomes of emergency department patients with altered mental status: a randomized controlled trial.
Trial report in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Structure and Outcomes of Educational Programs for Training Non-electroencephalographers in Performing and Screening Adult EEG: A Systematic Review.Neurocritical care · 2021Pooled it
- Point-of-care electroencephalography enables rapid evaluation and management of non-convulsive seizures and status epilepticus in the emergency department.Journal of the American College of Emergency Physicians open · 2023Article
- Inclusion of older adults and reporting of consent processes in randomized controlled trials in the emergency department: A scoping review.Journal of the American College of Emergency Physicians open · 2022Article
- Simultaneous Heart Rate Variability and Electroencephalographic Monitoring in Children in the Emergency Department.Journal of child & adolescent trauma · 2021Article
- Midline and Parasagittal Seizures are Rare in Adult Patients.Neurocritical care · 2020Article
- Process Changes for Stroke Care and Electroencephalography on a Neurology Service in a Hospital at the Epicenter of the COVID-19 Pandemic.Frontiers in neurology · 2020Article
- Can patients with non-convulsive seizure be identified in the emergency department?World journal of emergency medicine · 2017Article
- Prevalence of epileptiform discharges in healthy 11- and 12-year-old children.Epilepsy & behavior : E&B · 2016Article
- Diagnostic accuracy of microEEG: a miniature, wireless EEG device.Epilepsy & behavior : E&B · 2014Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesAltered mental status (AMS) is a common presentation in the emergency department (ED). A previous study revealed 78% electroencephalogram (EEG) abnormalities, including nonconvulsive seizure (NCS; 5%), in ED patients with AMS. The objective of this study was to assess the impact of EEG on clinical management and outcomes of ED patients with AMS.
methodsThis was a randomized controlled trial at two urban teaching hospitals. Adult patients (≥18 years old) with AMS were included. Excluded patients had immediately correctable AMS (e.g., hypoglycemia) or were admitted before enrollment. Patients were randomized to routine care (control) or routine care plus EEG (intervention). Research assistants used a scalp electrode set with a miniature, wireless EEG device (microEEG) to record standard 30-minute EEGs at presentation, and results were reported to the ED attending physician by an off-site epileptologist within 30 minutes. Primary outcomes included changes in ED management (differential diagnosis, diagnostic work-up, and treatment plan from enrollment to disposition) as determined by surveying the treating physicians. Secondary outcomes were length of ED and hospital stay, intensive care unit (ICU) requirement, and in-hospital mortality.
resultsA total of 149 patients were enrolled (76 control and 73 intervention). Patients in the two groups were comparable at baseline. EEG in the intervention group revealed abnormal findings in 93% (95% confidence interval [CI] = 85% to 97%), including NCS in 5% (95% CI = 2% to 13%). Using microEEG was associated with change in diagnostic work-up in 49% (95% CI = 38% to 60%) of cases and therapeutic plan in 42% (95% CI = 31% to 53%) of cases immediately after the release of EEG results. Changes in probabilities of differential diagnoses and the secondary outcomes were not statistically significant between the groups.
conclusionsAn EEG can be obtained in the ED with minimal resources and can affect clinical management of AMS patients.
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