Evidence map›Paper›PMID 40108974›Full record

ArticleEpilepsia2025

Validation of a discrete electrographic seizure detection algorithm for extended-duration, reduced-channel wearable EEG.

Tyler J Newton, Mitchell A Frankel, Zoë Tosi, Avidor B Kazen, Vamshi K Muvvala, Tobias Loddenkemper, Mark C Spitz, Laura Strom, Daniel Friedman, Mark J Lehmkuhle

Abstract readValidation Study
In one paragraph

Article in Epilepsia, 2025. 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
–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

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
  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

10 authors.

Tyler J NewtonEpitel, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0002-1560-6553
Mitchell A FrankelEpitel, Salt Lake City, Utah, USA.
Zoë TosiEpitel, Salt Lake City, Utah, USA.
Avidor B KazenEpitel, Salt Lake City, Utah, USA.
Vamshi K MuvvalaEpitel, Salt Lake City, Utah, USA.
Tobias LoddenkemperDivision of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Mark C SpitzEpilepsy Section, Department of Neurology, University of Colorado, Aurora, Colorado, USA.
Laura StromEpilepsy Section, Department of Neurology, University of Colorado, Aurora, Colorado, USA.
Daniel FriedmanDepartment of Neurology, New York University Grossman School of Medicine, NYU Langone Health, New York, New York, USA.
Mark J LehmkuhleEpitel, Salt Lake City, Utah, USA.

Funding

Automated Seizure Detection for Home Seizure Monitoring with Epilog SensorsU44NS121562 · NINDS · EPITEL, INC. · PI LEHMKUHLE, MARK J. · 2021 to 2025
$6.3M
REMI Platform for Remote EEG MonitoringSB1NS100235 · NINDS · EPITEL, INC. · PI LEHMKUHLE, MARK J. · 2022 to 2024
$3.4M
EEG PatchR44NS100235 · NINDS · EPITEL, INC. · PI LEHMKUHLE, MARK J. · 2017 to 2019
$2.1M
EEG PatchR43NS100235 · NINDS · EPITEL, INC. · PI LEHMKUHLE, MARK J. · 2016 to 2016
$231k
NIH HHS R43NS100235NIH HHS R44NS100235NIH HHS SB1NS100235NIH HHS U44NS121562NINDS NIH HHS R43 NS100235NINDS NIH HHS R44 NS100235NINDS NIH HHS SB1 NS100235NINDS NIH HHS U44 NS121562
6 · The paper itself

Abstract

objectiveReduced-channel wearable electroencephalography (EEG) may overcome the accessibility and patient comfort limitations of traditional ambulatory electrographic seizure monitoring during extended-duration use. Automated algorithms are necessary for review of extended-duration reduced-channel EEG, yet current clinical support software is designed only for full-montage recordings.

methodsThe performance of a novel automated seizure detection algorithm for reduced-channel EEG (Epitel) was evaluated in a clinical validation study involving 50 participants (31 with seizures) with diverse demographic and seizure representation.

resultsThe algorithm demonstrated an event-level sensitivity of 86.2% (95% confidence interval [CI] = 79.5%-93.2%) and a false detection rate of .162 per hour (95% CI = .116-.221), which is comparable to the performance of current clinical software for full-montage EEG. Performance varied by electrographic seizure type, with 91.4% sensitivity for focal evolving to generalized seizures, 86.7% for generalized seizures, and 77.3% for focal seizures. The algorithm maintained robust performance in both pediatric participants aged 6-21 years (83% sensitivity) and adults aged 22+ years (90% sensitivity), as well as in ambulatory (80%) and epilepsy monitoring unit (EMU) monitoring environments (87.5%). The false detection rate in ambulatory monitoring environments (.290 false positive [FP] detections/h), all of which involved pediatric participants, was notably higher than in the EMU (.136 FP/h), indicating an area with clear need for improvement for unrestricted at-home monitoring. The algorithm's supplemental Confidence metric, designed to engender trust in the algorithm, showed a strong correlation with detection precision. SIGNIFICANCE: These results suggest that this algorithm can provide crucial support for review of extended-duration reduced-channel wearable EEG, enabling electrographic seizure monitoring with no restrictions on a person's daily life.

Indexed as

AlgorithmsElectroencephalographySeizuresWearable Electronic DevicesAdolescentAdultAgedChildDetection AlgorithmsFemaleHumansMaleMiddle AgedMonitoring, AmbulatorySensitivity and SpecificityYoung AdultEEGelectroencephalographymachine learningseizure detectionwearables

Identifiers

PMID40108974
PMCPMC12291015

What OpenQuestion holds

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Registered trials

None linked

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.