Objectives: To compare the performance of critical care providers with that of electroencephalography experts in identifying seizures using quantitative electroencephalography display tools. Design: Diagnostic accuracy comparison among healthcare provider groups. Setting: Multispecialty quaternary children’s hospital in Canada. Subjects: ICU fellows, ICU nurses, neurophysiologists, and electroencephalography technologists. Intervention: Two-hour standardized one-on-one training, followed by a supervised individual review of 27 continuous electroencephalography recordings with the task of identifying individual seizures on eight-channel amplitude-integrated electroencephalography and color density spectral array displays. Measurements and Main Results: Each participant reviewed 27 continuous electroencephalograms comprising 487 hours of recording containing a total of 553 seizures. Performance for seizure identification was compared among groups using a nested model analysis with adjustment for interparticipant variability within groups and collinearity among recordings. Using amplitude-integrated electroencephalography, sensitivity for seizure identification was comparable among ICU fellows (83.8%), ICU nurses (73.1%), and neurophysiologists (81.5%) but lower among electroencephalographic technologists (66.7%) (p = 0.003). Using color density spectral array, sensitivity was comparable among ICU fellows (82.4%), ICU nurses (88.2%), neurophysiologists (83.3%), and electroencephalographic technologists (73.3%) (p = 0.09). Daily false-positive rates were also comparable among ICU fellows (2.8 for amplitude-integrated electroencephalography, 7.7 for color density spectral array), ICU nurses (4.2, 7.1), neurophysiologists (1.2, 1.5), and electroencephalographic technologists (0, 0) (p = 0.41 for amplitude-integrated electroencephalography; p = 0.13 for color density spectral array). However, performance varied greatly across individual electroencephalogram recordings. Professional background generally played a greater role in determining performance than individual skill or electroencephalogram recording characteristics. Conclusions: Following standardized training, critical care providers and electroencephalography experts displayed similar performance for identifying individual seizures using both amplitude-integrated electroencephalography and color density spectral array displays. Although these quantitative electroencephalographic trends show promise as a tool for bedside seizure screening by critical care providers, these findings require confirmation in a real-world ICU environment and in daily clinical use. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (https://ift.tt/29S62lw). Supported, in part, by research grants from the Physicians’ Services Incorporated Foundation, The Hospital for Sick Children Foundation, and the Canadian Institutes of Health Research. Dr. Hahn’s institution received funding from Physician’s Services Incorporated Foundation, Canadian Institutes of Health Research, and the Hospital for Sick Children Foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: cecil.hahn@sickkids.ca Copyright © by 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2MT7s1l
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Video from Norwegian TAS3 training-Rapid Extraction: From N.Z. ..: "The whole front of the car had been ripped away on impact of the cr...
-
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2EdTCxV
-
Reuters Health News from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2rI2pFX
-
The new system cuts out the practice of “over triaging calls” and uses an algorithm to suggest to dispatchers what resources are needed fr...
-
Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxyg...
-
The new system is meant to allow people who are hard of hearing, speech-impaired or unable to talk safely on the phone to connect with emerg...
-
Objective: It was hypothesized that adding dedicated afternoon rounds for patients’ families to supplement standard family support would imp...
-
International Journal of Environmental Research... Latest Results for Sleep and BreathingIntermitt... Evolutionary Biology News -- S...
-
The American Journal of Emergency Medicine from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2iKBYYz
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου