The standardization debate: A conflation trap in critical care electroencephalography.
The standardization debate: A conflation trap in critical care electroencephalography.
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DOI：
10.1016/j.seizure.2014.09.017
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发表时间：
2015-01
影响因子：
3
通讯作者：
Westover, M. Brandon
中科院分区：
文献类型：
--
作者：
Ng, Marcus C.;Gaspard, Nicolas;Cole, Andrew J.;Hoch, Daniel B.;Cash, Sydney S.;Bianchi, Matt;O'Rourke, Deirdre A.;Rosenthal, Eric S.;Chu, Catherine J.;Westover, M. Brandon
关键词：
关于重症监护室（ICU）各种病理连续脑电图（cEEG）结果的临床意义的持续不确定性促使努力标准化ICU cEEG术语和随后的辩论。我们着手了解这场辩论的原因，并设法得到令人满意的解决办法。我们回顾了支持和反对标准化的立场，并考察了其更深层次的哲学基础。我们发现，支持和反对标准化的立场并非根本不可调和。相反，这两种观点都源于脑电图经典方法中的三个基本步骤的合并，我们称之为“描述”、“解释”和“处方”。使用现实世界的例子，我们展示了这种合并如何在脑电图学家中产生混乱的临床推理和无效的辩论，从而转化为治疗临床医生的混乱。我们提出了一种中间方式，明智地使用标准化术语和临床推理来解开这些关键步骤，并按适当的顺序应用它们。本文提出的ICU脑电图结果的系统方法不仅解决了标准化的争论，而且通过帮助脑电图医师在面对不确定性时为脑电图结果分配适当的权重来澄清临床推理。
Persistent uncertainty over the clinical significance of various pathological continuous electroencephalography (cEEG) findings in the intensive care unit (ICU) has prompted efforts to standardize ICU cEEG terminology and an ensuing debate. We set out to understand the reasons for, and a satisfactory resolution to, this debate. We review the positions for and against standardization, and examine their deeper philosophical basis. We find that the positions for and against standardization are not fundamentally irreconcilable. Rather, both positions stem from conflating the three cardinal steps in the classic approach to EEG, which we term “description”, “interpretation”, and “prescription”. Using real-world examples we show how this conflation yields muddled clinical reasoning and unproductive debate among electroencephalographers that is translated into confusion among treating clinicians. We propose a middle way that judiciously uses both standardized terminology and clinical reasoning to disentangle these critical steps and apply them in proper sequence. The systematic approach to ICU cEEG findings presented herein not only resolves the standardization debate but also clarifies clinical reasoning by helping electroencephalographers assign appropriate weights to cEEG findings in the face of uncertainty.
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影响因子：
9.9
作者：
Kaplan, Peter W.;Benbadis, Selim R.
通讯作者：
Benbadis, Selim R.
影响因子：
2.7
作者：
Arif, Hiba;Hirsch, Lawrence J.
通讯作者：
Hirsch, Lawrence J.
影响因子：
5.6
作者：
Beniczky, Sandor;Hirsch, Lawrence J.;Trinka, Eugen
通讯作者：
Trinka, Eugen
影响因子：
1.2
作者：
Hopp, Jennifer L.;Sanchez, Ana;Barry, Elizabeth
通讯作者：
Barry, Elizabeth
DOI：
10.1097/wnp.0b013e3182a73db9
发表时间：
2013-10
期刊：
Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
影响因子：
--
作者：
Faigle R;Sutter R;Kaplan PW
通讯作者：
Kaplan PW