ArticleJournal of clinical neurophysiology : official publication of the American Electroencephalographic Society2017
Performance of Spectrogram-Based Seizure Identification of Adult EEGs by Critical Care Nurses and Neurophysiologists.
Article in Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 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
- Educational initiatives for electroencephalography in the critical care setting: a systematic review and meta-analysis.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Pooled it
- Automating Critical Care EEG: Enhancing Accuracy, Efficiency, and Patient Outcomes in Critical Care.Epilepsy currents · 2026Article
- Clinical Electroencephalography for Anesthesiologists and Intensivists: Part 2-Physiologic Signatures and Active Management.Anesthesiology · 2025Review
- Competence of healthcare professionals performing electroencephalography test: A systematic review.Clinical neurophysiology practice · 2025Review
- Using artificial intelligence to optimize anti-seizure treatment and EEG-guided decisions in severe brain injury.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Utility of Quantitative EEG in Neurological Emergencies and ICU Clinical Practice.Brain sciences · 2024Review
- Utility and rationale for continuous EEG monitoring: a primer for the general intensivist.Critical care (London, England) · 2024Review
- Landscape and future directions of machine learning applications in closed-loop brain stimulation.NPJ digital medicine · 2023Review
- Quantitative EEG-Based Seizure Estimation in Super-Refractory Status Epilepticus.Neurocritical care · 2022Article
- Using EEG in Resource-Limited Areas: Comparing Qualitative and Quantitative Interpretation Methods in Cerebral Malaria.Pediatric neurology · 2022Article
- Electrographic Seizure Detection by Neuroscience Intensive Care Unit Nurses via Bedside Real-Time Quantitative EEG.Neurology. Clinical practice · 2021Article
- Monitoring the Burden of Seizures and Highly Epileptiform Patterns in Critical Care with a Novel Machine Learning Method.Neurocritical care · 2021Article
- Electroencephalogram Monitoring in Critical Care.Seminars in neurology · 2020Review
- A standardized nomenclature for spectrogram EEG patterns: Inter-rater agreement and correspondence with common intensive care unit EEG patterns.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2020Article
- Regularization of Deep Neural Networks for EEG Seizure Detection to Mitigate Overfitting.Proceedings : Annual International Computer Software and Applications Conference. COMPSAC · 2020Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeContinuous EEG screening using spectrograms or compressed spectral arrays (CSAs) by neurophysiologists has shorter review times with minimal loss of sensitivity for seizure detection when compared with visual analysis of raw EEG. Limited data are available on the performance characteristics of CSA-based seizure detection by neurocritical care nurses.
methodsThis is a prospective cross-sectional study that was conducted in two academic neurocritical care units and involved 33 neurointensive care unit nurses and four neurophysiologists.
resultsAll nurses underwent a brief training session before testing. Forty two-hour CSA segments of continuous EEG were reviewed and rated for the presence of seizures. Two experienced clinical neurophysiologists masked to the CSA data performed conventional visual analysis of the raw EEG and served as the gold standard. The overall accuracy was 55.7% among nurses and 67.5% among neurophysiologists. Nurse seizure detection sensitivity was 73.8%, and the false-positive rate was 1-per-3.2 hours. Sensitivity and false-alarm rate for the neurophysiologists was 66.3% and 1-per-6.4 hours, respectively. Interrater agreement for seizure screening was fair for nurses (Gwet AC1 statistic: 43.4%) and neurophysiologists (AC1: 46.3%).
conclusionsTraining nurses to perform seizure screening utilizing continuous EEG CSA displays is feasible and associated with moderate sensitivity. Nurses and neurophysiologists had comparable sensitivities, but nurses had a higher false-positive rate. Further work is needed to improve sensitivity and reduce false-alarm rates.
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Registered trials
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