Shellhaas Renée A, Gallagher Paul R, Clancy Robert R
Division of Pediatric Neurology, Department of Pediatrics and Communicable Diseases, Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI, USA.
J Pediatr. 2008 Sep;153(3):369-74. doi: 10.1016/j.jpeds.2008.03.004. Epub 2008 Apr 18.
To determine the agreement among conventional electroencephalography (CEEG) terminology background classification and a simple and an advanced amplitude-integrated EEG (aEEG) system, and to evaluate whether aEEG interpreter experience or electrographic seizures affect this agreement.
CEEG background was classified by traditional interpretive criteria for 144 neonatal recordings, from which a single channel was converted to aEEGs. These aEEGs were independently interpreted by neonatologists according to the simple and advanced classification systems.
Interreader agreement was better with the simple aEEG system compared with the advanced aEEG system (multirater kappa, 0.66 vs 0.44). Fair-to-moderate agreement was found between both of the aEEG classification systems and CEEG (simple: kappa, 0.34 to 0.45; advanced: kappa, 0.36 to 0.45). Agreement did not vary significantly based on the aEEG interpreter experience or the presence of seizures.
Neonatologists found better agreement using the simple aEEG system regardless of their expertise or the presence of seizures. This finding has implications for patient selection in future multicenter neonatal neuroprotection studies.
确定传统脑电图（CEEG）术语背景分类与简单及高级振幅整合脑电图（aEEG）系统之间的一致性，并评估aEEG解读经验或脑电图癫痫发作是否会影响这种一致性。
根据传统解读标准对144份新生儿记录的CEEG背景进行分类，从中选取一个通道转换为aEEG。这些aEEG由新生儿科医生根据简单和高级分类系统独立解读。
与高级aEEG系统相比，简单aEEG系统的读者间一致性更好（多评分者kappa值，0.66对0.44）。两个aEEG分类系统与CEEG之间的一致性为中等至良好（简单：kappa值，0.34至0.45；高级：kappa值，0.36至0.45）。一致性不会因aEEG解读经验或癫痫发作的存在而有显著差异。
无论新生儿科医生的专业水平或是否存在癫痫发作，使用简单aEEG系统时他们发现的一致性更好。这一发现对未来多中心新生儿神经保护研究中的患者选择具有启示意义。
