Inter-rater agreement on identification of electrographic seizures and periodic discharges in ICU EEG recordings.

Journal Article (Journal Article)

OBJECTIVE: This study investigated inter-rater agreement (IRA) among EEG experts for the identification of electrographic seizures and periodic discharges (PDs) in continuous ICU EEG recordings. METHODS: Eight board-certified EEG experts independently identified seizures and PDs in thirty 1-h EEG segments which were selected from ICU EEG recordings collected from three medical centers. IRA was compared between seizure and PD identifications, as well as among rater groups that have passed an ICU EEG Certification Test, developed by the Critical Care EEG Monitoring Research Consortium (CCEMRC). RESULTS: Both kappa and event-based IRA statistics showed higher mean values in identification of seizures compared to PDs (k=0.58 vs. 0.38; p<0.001). The group of rater pairs who had both passed the ICU EEG Certification Test had a significantly higher mean IRA in comparison to rater pairs in which neither had passed the test. CONCLUSIONS: IRA among experts is significantly higher for identification of electrographic seizures compared to PDs. Additional instruction, such as the training module and certification test developed by the CCEMRC, could enhance this IRA. SIGNIFICANCE: This study demonstrates more disagreement in the labeling of PDs in comparison to seizures. This may be improved by education about standard EEG nomenclature.

Full Text

Duke Authors

Cited Authors

  • Halford, JJ; Shiau, D; Desrochers, JA; Kolls, BJ; Dean, BC; Waters, CG; Azar, NJ; Haas, KF; Kutluay, E; Martz, GU; Sinha, SR; Kern, RT; Kelly, KM; Sackellares, JC; LaRoche, SM

Published Date

  • September 2015

Published In

Volume / Issue

  • 126 / 9

Start / End Page

  • 1661 - 1669

PubMed ID

  • 25481336

Pubmed Central ID

  • PMC4439396

Electronic International Standard Serial Number (EISSN)

  • 1872-8952

Digital Object Identifier (DOI)

  • 10.1016/j.clinph.2014.11.008


  • eng

Conference Location

  • Netherlands