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ArticleActa anaesthesiologica Scandinavica2025

Accuracy of EEG Slow Wave Activity in Predicting Favorable Outcome in Patients With Hypoxic Brain Injury-A Protocol for a Substudy of the STEPCARE Trial.

Johanna Hästbacka, Erik Westhall, Marion Moseby-Knappe, Marjaana Tiainen, Anna Lybeck, Matti Reinikainen, Helena Levin, Markus B Skrifvars, Joonas Tirkkonen, Janus C Jakobsen and 4 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Acta anaesthesiologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06564675 (Accuracy of EEG Slow Wave Activity in Predicting Favourable Outcome in Patients With Hypoxic Brain Injury - A Substudy of STEPCARE Trial), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT06564675 recruitingnot on this map

Accuracy of EEG Slow Wave Activity in Predicting Favourable Outcome in Patients With Hypoxic Brain Injury - A Substudy of STEPCARE Trial

TypeobservationalSponsorUniversity of HelsinkiRan2023 to 2027Enrolled300ConditionsOut-Of-Hospital Cardiac ArrestArmsC-Trend Index
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

14 authors.

Johanna HästbackaDepartment of Intensive Care, Faculty of Medicine and Health Technology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University, Tampere, Finland.ORCID 0000-0002-3613-7231
Erik WesthallDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Marion Moseby-KnappeDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Marjaana TiainenDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Anna LybeckDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.ORCID 0000-0001-7574-3958
Matti ReinikainenDepartment of Anaesthesiology and Intensive Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0001-6878-3740
Helena LevinDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Markus B SkrifvarsDepartment of Anaesthesia and Intensive Care Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID 0000-0002-0341-0262
Joonas TirkkonenDepartment of Intensive Care, Faculty of Medicine and Health Technology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University, Tampere, Finland.
Janus C JakobsenCopenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Niklas NielsenDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Jussi ToppilaDepartment of Clinical Neurophysiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID 0000-0001-9418-2519
Marjolein M AdmiraalDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.ORCID 0000-0002-3670-0370
Jukka KortelainenCenter for Machine Vision and Signal Analysis, University of Oulu, Oulu, Finland.

Funding

Academy of FinlandFinska LäkaresällskapetMedisinska Understödsföreningen Liv och HälsaSigrid Jusélius FoundationSkåne University Hospital foundationsTampere University Hospital, Wellbeing Services County of Pirkanmaa T63694The Swedish Research Council
6 · The paper itself

Abstract

backgroundEarly restitution of electroencephalogram (EEG) slow wave activity (SWA) may be able to predict favorable functional outcome after cardiac arrest. SWA can be monitored using the C-Trend Index, a recently developed dynamic numerical index computed using commercially available medical device software.

methodsThis is a pre-planned prospective substudy of the randomized controlled Sedation, TEmperature and Pressure after Cardiac Arrest and REsuscitation (STEPCARE) trial. With a factorial design, the STEPCARE trial evaluates the effects of three different interventions (sedation, temperature management, and mean arterial blood pressure) on functional outcomes in adult out-of-hospital cardiac arrest (OHCA) patients. We will record continuous EEG (cEEG) starting as early as possible after ICU admission. We will compare the accuracy (the proportion of correct predictions of all predictions) of C-Trend Index with that of blinded retrospective visual analysis of cEEG at 12 h after return of spontaneous circulation in predicting favorable functional outcome (modified Rankin Scale 0-3) 6 months after cardiac arrest. We aim to recruit 300 patients to show noninferiority in prognostic accuracy of the C-Trend Index compared with the visual analysis of cEEG, using a 2% limit for noninferiority. Furthermore, we will assess whether the therapeutic intervention related to sedation, carried out as a part of the STEPCARE trial modifies the performance of the EEG-based predictors.

conclusionThe study will compare the accuracy of SWA measured using C-Trend Index with the gold standard, visual analysis of cEEG, in predicting favorable functional outcome after OHCA. The study will also assess the effect of the sedation intervention of the STEPCARE trial on the predictive accuracy of C-Trend Index. If the accuracy of the C-Trend Index is non-inferior to the comparator's, it may provide a feasible and easy-to-learn bedside method, especially in hospitals with limited availability of neurophysiology expertise.

trial registrationClinicalTrials.gov identifier: NCT06564675.

Indexed as

ElectroencephalographyHypoxia, BrainOut-of-Hospital Cardiac ArrestAdultEquivalence Trials as TopicFemaleHumansHypothermia, InducedMaleObservational Studies as TopicPredictive Value of TestsPrognosisProspective StudiesRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID40958738
PMCPMC12441756

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Registered trials

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.