Interictal epileptiform discharge detection in EEG in different practice settings

Jonathan J. Halford, M. Brandon Westover, Suzette M. LaRoche, Micheal P. Macken, Ekrem Kutluay, Jonathan C. Edwards, Leonardo Bonilha, Giridhar P. Kalamangalam, Kan Ding, Jennifer L. Hopp, Amir Arain, Rachael A. Dawson, Gabriel U. Martz, Bethany J. Wolf, Chad G. Waters, Brian C. Dean

Research output: Contribution to journalArticle

Abstract

Objective: The goal of the study was to measure the performance of academic and private practice (PP) neurologists in detecting interictal epileptiform discharges in routine scalp EEG recordings. Methods: Thirty-five EEG scorers (EEGers) participated (19 academic and 16 PP) and marked the location of ETs in 200 30-second EEG segments using a web-based EEG annotation system. All participants provided board certification status, years of Epilepsy Fellowship Training (EFT), and years in practice. The Persyst P13 automated IED detection algorithm was also run on the EEG segments for comparison. Results: Academic EEGers had an average of 1.66 years of EFT versus 0.50 years of EFT for PP EEGers (P < 0.0001) and had higher rates of board certification. Inter-rater agreement for the 35 EEGers was fair. There was higher performance for EEGers in academics, with at least 1.5 years of EFT, and with American Board of Clinical Neurophysiology and American Board of Psychiatry and Neurology-E specialty board certification. The Persyst P13 algorithm at its default setting (perception value = 0.4) did not perform as well at the EEGers, but at substantially higher perception value settings, the algorithm performed almost as well human experts. Conclusions: Inter-rater agreement among EEGers in both academic and PP settings varies considerably. Practice location, years of EFT, and board certification are associated with significantly higher performance for IED detection in routine scalp EEG. Continued medical education of PP neurologists and neurologists without EFT is needed to improve routine scalp EEG interpretation skills. The performance of automated detection algorithms is approaching that of human experts.

Original languageEnglish (US)
Pages (from-to)375-380
Number of pages6
JournalJournal of Clinical Neurophysiology
Volume35
Issue number5
DOIs
StatePublished - Jan 1 2018

Fingerprint

Electroencephalography
Private Practice
Epilepsy
Certification
Scalp
Specialty Boards
Neurophysiology
Neurology
Medical Education
Psychiatry

Keywords

  • EEG
  • Epilepsy
  • Inter-rater agreement

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Halford, J. J., Westover, M. B., LaRoche, S. M., Macken, M. P., Kutluay, E., Edwards, J. C., ... Dean, B. C. (2018). Interictal epileptiform discharge detection in EEG in different practice settings. Journal of Clinical Neurophysiology, 35(5), 375-380. https://doi.org/10.1097/WNP.0000000000000492

Interictal epileptiform discharge detection in EEG in different practice settings. / Halford, Jonathan J.; Westover, M. Brandon; LaRoche, Suzette M.; Macken, Micheal P.; Kutluay, Ekrem; Edwards, Jonathan C.; Bonilha, Leonardo; Kalamangalam, Giridhar P.; Ding, Kan; Hopp, Jennifer L.; Arain, Amir; Dawson, Rachael A.; Martz, Gabriel U.; Wolf, Bethany J.; Waters, Chad G.; Dean, Brian C.

In: Journal of Clinical Neurophysiology, Vol. 35, No. 5, 01.01.2018, p. 375-380.

Research output: Contribution to journalArticle

Halford, JJ, Westover, MB, LaRoche, SM, Macken, MP, Kutluay, E, Edwards, JC, Bonilha, L, Kalamangalam, GP, Ding, K, Hopp, JL, Arain, A, Dawson, RA, Martz, GU, Wolf, BJ, Waters, CG & Dean, BC 2018, 'Interictal epileptiform discharge detection in EEG in different practice settings', Journal of Clinical Neurophysiology, vol. 35, no. 5, pp. 375-380. https://doi.org/10.1097/WNP.0000000000000492
Halford JJ, Westover MB, LaRoche SM, Macken MP, Kutluay E, Edwards JC et al. Interictal epileptiform discharge detection in EEG in different practice settings. Journal of Clinical Neurophysiology. 2018 Jan 1;35(5):375-380. https://doi.org/10.1097/WNP.0000000000000492
Halford, Jonathan J. ; Westover, M. Brandon ; LaRoche, Suzette M. ; Macken, Micheal P. ; Kutluay, Ekrem ; Edwards, Jonathan C. ; Bonilha, Leonardo ; Kalamangalam, Giridhar P. ; Ding, Kan ; Hopp, Jennifer L. ; Arain, Amir ; Dawson, Rachael A. ; Martz, Gabriel U. ; Wolf, Bethany J. ; Waters, Chad G. ; Dean, Brian C. / Interictal epileptiform discharge detection in EEG in different practice settings. In: Journal of Clinical Neurophysiology. 2018 ; Vol. 35, No. 5. pp. 375-380.
@article{b70d111ea9d143b980c43b285fe4af25,
title = "Interictal epileptiform discharge detection in EEG in different practice settings",
abstract = "Objective: The goal of the study was to measure the performance of academic and private practice (PP) neurologists in detecting interictal epileptiform discharges in routine scalp EEG recordings. Methods: Thirty-five EEG scorers (EEGers) participated (19 academic and 16 PP) and marked the location of ETs in 200 30-second EEG segments using a web-based EEG annotation system. All participants provided board certification status, years of Epilepsy Fellowship Training (EFT), and years in practice. The Persyst P13 automated IED detection algorithm was also run on the EEG segments for comparison. Results: Academic EEGers had an average of 1.66 years of EFT versus 0.50 years of EFT for PP EEGers (P < 0.0001) and had higher rates of board certification. Inter-rater agreement for the 35 EEGers was fair. There was higher performance for EEGers in academics, with at least 1.5 years of EFT, and with American Board of Clinical Neurophysiology and American Board of Psychiatry and Neurology-E specialty board certification. The Persyst P13 algorithm at its default setting (perception value = 0.4) did not perform as well at the EEGers, but at substantially higher perception value settings, the algorithm performed almost as well human experts. Conclusions: Inter-rater agreement among EEGers in both academic and PP settings varies considerably. Practice location, years of EFT, and board certification are associated with significantly higher performance for IED detection in routine scalp EEG. Continued medical education of PP neurologists and neurologists without EFT is needed to improve routine scalp EEG interpretation skills. The performance of automated detection algorithms is approaching that of human experts.",
keywords = "EEG, Epilepsy, Inter-rater agreement",
author = "Halford, {Jonathan J.} and Westover, {M. Brandon} and LaRoche, {Suzette M.} and Macken, {Micheal P.} and Ekrem Kutluay and Edwards, {Jonathan C.} and Leonardo Bonilha and Kalamangalam, {Giridhar P.} and Kan Ding and Hopp, {Jennifer L.} and Amir Arain and Dawson, {Rachael A.} and Martz, {Gabriel U.} and Wolf, {Bethany J.} and Waters, {Chad G.} and Dean, {Brian C.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/WNP.0000000000000492",
language = "English (US)",
volume = "35",
pages = "375--380",
journal = "Journal of Clinical Neurophysiology",
issn = "0736-0258",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Interictal epileptiform discharge detection in EEG in different practice settings

AU - Halford, Jonathan J.

AU - Westover, M. Brandon

AU - LaRoche, Suzette M.

AU - Macken, Micheal P.

AU - Kutluay, Ekrem

AU - Edwards, Jonathan C.

AU - Bonilha, Leonardo

AU - Kalamangalam, Giridhar P.

AU - Ding, Kan

AU - Hopp, Jennifer L.

AU - Arain, Amir

AU - Dawson, Rachael A.

AU - Martz, Gabriel U.

AU - Wolf, Bethany J.

AU - Waters, Chad G.

AU - Dean, Brian C.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: The goal of the study was to measure the performance of academic and private practice (PP) neurologists in detecting interictal epileptiform discharges in routine scalp EEG recordings. Methods: Thirty-five EEG scorers (EEGers) participated (19 academic and 16 PP) and marked the location of ETs in 200 30-second EEG segments using a web-based EEG annotation system. All participants provided board certification status, years of Epilepsy Fellowship Training (EFT), and years in practice. The Persyst P13 automated IED detection algorithm was also run on the EEG segments for comparison. Results: Academic EEGers had an average of 1.66 years of EFT versus 0.50 years of EFT for PP EEGers (P < 0.0001) and had higher rates of board certification. Inter-rater agreement for the 35 EEGers was fair. There was higher performance for EEGers in academics, with at least 1.5 years of EFT, and with American Board of Clinical Neurophysiology and American Board of Psychiatry and Neurology-E specialty board certification. The Persyst P13 algorithm at its default setting (perception value = 0.4) did not perform as well at the EEGers, but at substantially higher perception value settings, the algorithm performed almost as well human experts. Conclusions: Inter-rater agreement among EEGers in both academic and PP settings varies considerably. Practice location, years of EFT, and board certification are associated with significantly higher performance for IED detection in routine scalp EEG. Continued medical education of PP neurologists and neurologists without EFT is needed to improve routine scalp EEG interpretation skills. The performance of automated detection algorithms is approaching that of human experts.

AB - Objective: The goal of the study was to measure the performance of academic and private practice (PP) neurologists in detecting interictal epileptiform discharges in routine scalp EEG recordings. Methods: Thirty-five EEG scorers (EEGers) participated (19 academic and 16 PP) and marked the location of ETs in 200 30-second EEG segments using a web-based EEG annotation system. All participants provided board certification status, years of Epilepsy Fellowship Training (EFT), and years in practice. The Persyst P13 automated IED detection algorithm was also run on the EEG segments for comparison. Results: Academic EEGers had an average of 1.66 years of EFT versus 0.50 years of EFT for PP EEGers (P < 0.0001) and had higher rates of board certification. Inter-rater agreement for the 35 EEGers was fair. There was higher performance for EEGers in academics, with at least 1.5 years of EFT, and with American Board of Clinical Neurophysiology and American Board of Psychiatry and Neurology-E specialty board certification. The Persyst P13 algorithm at its default setting (perception value = 0.4) did not perform as well at the EEGers, but at substantially higher perception value settings, the algorithm performed almost as well human experts. Conclusions: Inter-rater agreement among EEGers in both academic and PP settings varies considerably. Practice location, years of EFT, and board certification are associated with significantly higher performance for IED detection in routine scalp EEG. Continued medical education of PP neurologists and neurologists without EFT is needed to improve routine scalp EEG interpretation skills. The performance of automated detection algorithms is approaching that of human experts.

KW - EEG

KW - Epilepsy

KW - Inter-rater agreement

UR - http://www.scopus.com/inward/record.url?scp=85056558855&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056558855&partnerID=8YFLogxK

U2 - 10.1097/WNP.0000000000000492

DO - 10.1097/WNP.0000000000000492

M3 - Article

VL - 35

SP - 375

EP - 380

JO - Journal of Clinical Neurophysiology

JF - Journal of Clinical Neurophysiology

SN - 0736-0258

IS - 5

ER -