Prospective evaluation of interrater agreement between EEG technologists and neurophysiologists

Abstract We aim to prospectively investigate, in a large and heterogeneous population, the electroencephalogram (EEG)-reading performances of EEG technologists. A total 8 technologists 5 certified neurophysiologists independently analyzed 20-min recordings. Interrater agreement (IRA) for predefined pattern identification between neurophysiologits was assessed using percentage (PA) Gwet-AC1. Among 1528 recordings, PA [95% confidence interval] interrater (IRA, AC1) values were as follows: status epilepticus (SE) seizures, 97% [96–98%], AC1 kappa = 0.97; interictal epileptiform discharges, 78% [76–80%], 0.63; conclusion dichotomized “normal” versus “pathological”, 83.6% [82–86%], 0.71. identified SE seizures with 99% [98–99%] negative predictive value, whereas positive (PPVs) 48% [34–62%] 35% [20–53%], respectively. The PPV normal EEGs 72% [68–76%]. seizure detection impaired poorly cooperating patients (SE seizures; p < 0.001), intubated older (SE; confirmed epilepsy (seizures; 0.004). ictal features few false negatives but high positives, good PPV. absence reported by can be reassuring; however, traces should reviewed before taking action.