Evidence map›Paper›PMID 39773282›Full record

Trial reportCritical care (London, England)2025

Efficacy of delivery of care with Tele-continuous EEG in critically ill patients: a multicenter randomized controlled trial (Tele-cRCT study) study.

Chusak Limotai, Suda Jirasakuldej, Sattawut Wongwiangiunt, Tipakorn Tumnark, Piradee Suwanpakdee, Kwuanrat Wangponpattanasiri, Piyanuch Rakchue, Chaiwiwat Tungkasereerak, Polchai Pleumpanupatand, Phopsuk Tansuhaj and 55 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
  6. 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

65 authors.

Chusak LimotaiDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Suda JirasakuldejChulalongkorn Comprehensive Epilepsy Center of Excellence, The Thai Red Cross Society, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Sattawut WongwiangiuntDivision of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Tipakorn TumnarkNational Neurological Institute, Bangkok, Thailand.
Piradee SuwanpakdeeDivision of Neurology, Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand.
Kwuanrat WangponpattanasiriDivision of Neurology, Department of Medicine, Lerdsin Hospital, Bangkok, Thailand.
Piyanuch RakchueSurat Thani Hospital, Ministry of Public Health, Surat Thani, Thailand.
Chaiwiwat TungkasereerakMaharat Nakhon Ratchasima Hospital, Ministry of Public Health, Nakhon Ratchasima, Thailand.
Polchai PleumpanupatandBuddhachinaraj Hospital, Ministry of Public Health, Phitsanulok, Thailand.
Phopsuk TansuhajChiangrai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai, Thailand.
Phattarawin EkkachonMaharaj Nakhon Si Thammarat Hospital, Ministry of Public Health, Nakhon Si Thammarat, Thailand.
Songchai KittipanprayoonHatyai Hospital, Ministry of Public Health, Songkhla, Thailand.
Apiwoot KerddonfagQueen Savang Vadhana Memorial Hospital, The Thai Red Cross Society, Chonburi, Thailand.
Thippamas PobsukChonburi Hospital, Ministry of Public Health, Chonburi, Thailand.
Anuchate PattanateepaponDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Kammant PhanthumchindaDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Nijasri C SuwanwelaDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Iyavut ThaipisuttikulDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Kanokwan BoonyapisitDivision of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Atiporn IngsathitDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Oraluck PattanaprateepDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
John AttiaSchool of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia.
Gareth J McKayCentre for Public Health, Queen's University Belfast, Belfast, UK.
Andrea O RossettiDepartment of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Ammarin ThakkinstianDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand. ammarin.tha@mahidol.edu.
Chutima RukrungDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Patcharapun KangsananontDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Jeerawan MokkaewDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Nittaya PhayaphDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Supak PukpramanDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Warangkana RitrhathonDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Youwarat JarungjitapinanDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Jintana PinpradabDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Netphit KhamhoiDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Mayuree NookaewDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Patchareeporn ChauywangDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Pichai RojdmapitayakornDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Paworamon SribussaraDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Wasunon TinroongrojDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Wisan TeeratantikanonDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Tabtim ChongsuvivatwongDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Watchara ViratyapornDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Witoon JantararotaiDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Komkrit PanyawattanakitDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Nopparat RujirarongruengDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Pornnapat DamthongDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Pattama UdomDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Molvipa SiengsuwanDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Phatcharamai PhonprasoriDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Karnpidcha WanmuangDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Nattawut UnwanathamDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Sasivimol RattanasiriDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Kunlawat ThadaniponDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Panutchaya NoivongDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Sirincha PitipanyakulDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Watchara RattanachaisitDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Wichuta MuangthongDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Rachasiri WittayawisawasakulDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Sunisa DeerassameeDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Wannaporn RuayruenDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Supinya HomgrunjarutDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Sunisa DeerassameeDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Yupapron LedprasedDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Maturos PankongDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.
Pentip RattanayuvakornDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Rachatevi, Bangkok, 10400, Thailand.

Funding

Thailand Research Fund, the National Research Council of Thailand RSA6280071
6 · The paper itself

Abstract

backgroundContinuous electroencephalography (cEEG) has been recommended in critically ill patients although its efficacy for improving patients' functional status remains unclear. This study aimed to compare the efficacy of Tele-cEEG with Tele-routine EEG (Tele-rEEG), in terms of seizure detection rate, mortality and functional outcomes.

methodsThis study is a 3-year randomized, controlled, parallel, multicenter trial, conducted in eight regional hospitals across Thailand. Eligible participants were critically ill patients aged ≥ 15 years and at-risk for developing nonconvulsive seizure (NCS)/nonconvulsive status epilepticus (NCSE). Study interventions were 24-72 h Tele-cEEG versus 30-min Tele-rEEG. Study outcomes were seizure detection rate, mortality and functional outcomes (mRS), assessed at hospital discharge, ≤ 7 days, 3-, 6-, 9-months and 1 year.

resultsTwo hundred and fifty-four patients were randomized, 128 and 126 patients received Tele-cEEG and Tele-rEEG, respectively. NCS/NCSE were detected more commonly in the Tele-cEEG (21.88%) than Tele-rEEG arm (14.29%) but this was not statistically significant (p = 0.116). Intention-to-treat, per-protocol and as-treated analysis showed non-significant differences in mortality at all assessment periods, with corresponding mortality rates of 10.03% (Tele-cEEG) versus 10.10% (Tele-rEEG) (p = 0.894), 9.67% versus 9.06% (p = 0.833) and 10.34% versus 9.06% (p = 0.600), respectively. Functional outcome was also not significantly different in all analyses.

conclusionsBoth Tele-cEEG and Tele-rEEG are feasible, although Tele-EEG requires additional EEG specialists, budget, and computational resources. While Tele-cEEG may help detect NCS/NCSE, this study had limited power to detect its efficacy in reducing mortality or improving functional outcomes. In limited-resource settings, Tele-rEEG approximating 30 min or longer offers a feasible and potentially valuable initial screening tool for critically ill patients at-risk of seizures. However, where Tele-cEEG is readily available, it remains the recommended approach. Trial registration Thai Clinical Trials Registry (TTCTR20181022002); Registered 22 October 2018.

Indexed as

Critical IllnessElectroencephalographyTelemedicineAdultAgedDelivery of Health CareFemaleHumansIntensive Care UnitsMaleMiddle AgedSeizuresStatus EpilepticusThailandCritically ill patientsRandomized controlled trialTele-continuous EEGTele-cRCT

Identifiers

PMID39773282
PMCPMC11707894

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