Evidence map›Paper›PMID 34763248›Full record

ArticlePediatric neurology2022

Using EEG in Resource-Limited Areas: Comparing Qualitative and Quantitative Interpretation Methods in Cerebral Malaria.

Alexander Andrews, Tesfaye Zelleke, Rima Izem, Jiaxiang Gai, Dana Harrar, Jessica Mvula, Douglas G Postels

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Alexander AndrewsDepartment of Pediatrics, MedStar Georgetown University Hospital, Washington, District of Columbia.
Tesfaye ZellekeDivision of Neurology, The George Washington University School of Medicine/Children's National Medical Center, Washington, District of Columbia.
Rima IzemDivision of Biostatistics and Study Methodology, Children's National Research Institute, Washington, District of Columbia; Division of Epidemiology, The George Washington University School of Public Health, Washington, District of Columbia; Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia.
Jiaxiang GaiDivision of Biostatistics and Study Methodology, Children's National Research Institute, Washington, District of Columbia.
Dana HarrarDivision of Neurology, The George Washington University School of Medicine/Children's National Medical Center, Washington, District of Columbia.
Jessica MvulaDepartment of Paediatrics, Mzuzu Central Hospital, Mzuzu, Malawi; Ministry of Health, Mzuzu, Republic of Malawi.
Douglas G PostelsDivision of Neurology, The George Washington University School of Medicine/Children's National Medical Center, Washington, District of Columbia; Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi. Electronic address: dpostels@childrensnational.org.
Children's National · USGeorgetown University · USMzuzu University · MW

Funding

NIAID NIH HHS Y99 AI999999
6 · The paper itself

Abstract

backgroundOur goal was to compare the strength of association and predictive ability of qualitative and quantitative electroencephalographic (EEG) factors with the outcomes of death and neurological disability in pediatric cerebral malaria (CM).

methodsWe enrolled children with a clinical diagnosis of CM admitted to Queen Elizabeth Central Hospital (Blantyre, Malawi) between 2012 and 2017. A routine-length EEG was performed within four hours of admission. EEG data were independently interpreted using qualitative and quantitative methods by trained pediatric neurophysiologists. EEG interpreters were unaware of patient discharge outcome.

resultsEEG tracings from 194 patients were reviewed. Multivariate modeling revealed several qualitative and quantitative EEG variables that were independently associated with outcomes. Quantitative methods modeled on mortality had better goodness of fit than qualitative ones. When modeled on neurological morbidity in survivors, goodness of fit was better for qualitative methods. When the probabilities of an adverse outcome were calculated using multivariate regression coefficients, only the model of quantitative EEG variables regressed on the neurological sequelae outcome showed clear separation between outcome groups.

conclusionsMultiple qualitative and quantitative EEG factors are associated with outcomes in pediatric CM. It may be possible to use quantitative EEG factors to create automated methods of study interpretation that have similar predictive abilities for outcomes as human-based interpreters, a rare resource in many malaria-endemic areas. Our results provide a proof-of-concept starting point for the development of quantitative EEG interpretation and prediction methodologies useful in resource-limited settings.

Indexed as

ChildDeveloping CountriesElectroencephalographyFemaleHumansMalaria, CerebralMalawiMalePredictive Value of TestsAfricaComaElectroencephalographyMalaria

Identifiers

PMID34763248
PMCPMC8724416
OpenAlexW3206300552

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.