Interobserver Agreement in the Interpretation of EEG Patterns in Critically III Adults
Interobserver Agreement in the Interpretation of EEG Patterns in Critically III Adults
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DOI：
10.1097/wnp.0b013e318182ed67
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发表时间：
2008-10-01
影响因子：
2.4
通讯作者：
Kerrigan, John F.
中科院分区：
文献类型：
--
作者：
Gerber, Paula A.;Chapman, Kevin E.;Kerrigan, John F.
节律性和周期性脑电图在危重患者中的意义尚不清楚。需要一个通用的术语来促进对这些模式的研究，并且在使用这些术语时应显示出观察员的一致同意。作者使用标准化术语评估了观察者之间和观察者内部的一致性（Hirsch et a）。临床神经生理杂志2005,22:128-135)最近由美国临床神经生理学会提出。训练有素的脑电图学家观察了一系列来自危重成人的10秒脑电图样本（第一阶段），一组来自同一患者队列的>= 20分钟脑电图样本（第二阶段），然后重新评估第一组样本（第三阶段）。读者使用提出的术语对每个脑电图进行“评分”。对于每个可能的期限，使用两两kappa (K)值计算观察者间协议（阶段I和II）和观察者内部协议（阶段III）。对于节奏或周期模式的存在/缺失以及这些模式的定位，我们看到了超越偶然的适度一致。其他条款的协议不太公平。对于可选条款，观察员之间和观察员内部的协议始终低于强制性条款。即使使用标准化的术语，对节律性和周期性脑电图模式的描述也有很大的不同。需要进一步完善所提议的术语，以改善观察员之间和观察员内部的一致意见。
The significance of rhythmic and periodic EEG patterns in critically ill patients is unclear. A universal terminology is needed to facilitate study of these patterns, and consistent observer agreement should be demonstrated in its use. The authors evaluated inter-and intraobserver agreement using the standardized terminology (Hirsch et a],. J Clin Neurophysiol 2005,22:128-135) recently proposed by the American Clinical Neurophysiology Society. Trained electroencephalographers viewed a series of 10-second EEG samples from critically ill adults (phase I), a set of >= 20-minute EEGs from the same patient cohort (phase II), and then reevaluated the first sample set (phase III). The readers used the proposed terminology to "score" each EEG. For each possible term, interobserver agreement (phases I and II) and intraobserver agreement (phase III) were calculated using pairwise kappa (K) values. Moderate agreement beyond chance was seen for the presence/absence of rhythmic or periodic patterns and for localization of these patterns. Agreement for other terms was slight to fair. Inter- and intraobserver agreement were consistently lower for optional terms than mandatory terms. Even when standardized terminology is used, the description of rhythmic and periodic EEG patterns varies significantly. Further refinement of the proposed terminology is required to improve inter- and intraobserver agreement.