Department of Medicine, The University of Melbourne, Australia.
Clin Neurophysiol. 2011 Jun;122(6):1086-90. doi: 10.1016/j.clinph.2010.10.048. Epub 2010 Dec 13.
While there are well-established guidelines for optimum video-EEG monitoring (VEM), the process of reviewing VEM data varies amongst centres. In this study, we compared continuous with sampled reviewing of VEM data to assess whether their diagnostic yield differs.
VEM data acquired from 50 consecutive patients (31 females) admitted for VEM were reviewed by two independent electroencephalographers, one using the continuous review method, and the other sampling the first five minutes of each hour together with events identified by push buttons and automated spike detection software. Overall agreement between reviewers was calculated using the Kappa statistic. Comparison between the total number of clinical events detected by the two methods was done by Pearson's correlation coefficient.
A substantial number of events were missed using sampled review. Despite this, there was excellent agreement between the two methods on the final electro-clinical diagnosis for each patient (Kappa=0.89).
In our laboratory, continuous VEM more comprehensively captured information of interest, but it did not substantially alter the final electro-clinical diagnosis.
Sampled review of VEM data captures sufficient data to reliably make accurate clinical decisions. It may be considered as a more cost and labor efficient alternative to continuous review.
尽管已有针对最佳视频-脑电图监测（VEM）的既定指南，但各中心在审查 VEM 数据的过程中存在差异。本研究比较了连续与抽样审查 VEM 数据，以评估它们的诊断效果是否存在差异。
对 50 例连续患者（31 名女性）的 VEM 数据进行回顾性分析，由两位独立的脑电图医师进行审查，一位采用连续审查方法，另一位则对每小时的前 5 分钟进行抽样，并结合按钮事件和自动尖峰检测软件进行审查。采用 Kappa 统计量计算两位审阅者之间的总体一致性。采用 Pearson 相关系数比较两种方法检测到的总临床事件数。
抽样审查会遗漏大量的事件。尽管如此，两种方法在每位患者的最终电临床诊断上具有极好的一致性（Kappa=0.89）。
在我们的实验室中，连续 VEM 更全面地捕捉了感兴趣的信息，但并未对最终的电临床诊断产生实质性影响。
抽样审查 VEM 数据可以捕获足够的数据，从而可靠地做出准确的临床决策。与连续审查相比，它可能是一种更具成本效益和劳动效率的替代方法。
