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经过正规培训后神经科住院医师脑电图解读的成功率

The Success Rate of Neurology Residents in EEG Interpretation After Formal Training.

作者信息

Dericioglu Nese, Ozdemir Pınar

机构信息

1 Department of Neurology, Hacettepe University, Ankara, Turkey.

2 Department of Biostatistics, Hacettepe University, Ankara, Turkey.

出版信息

Clin EEG Neurosci. 2018 Mar;49(2):136-140. doi: 10.1177/1550059417736445. Epub 2017 Oct 10.

Abstract

EEG is an important tool for neurologists in both diagnosis and classification of seizures. It is not uncommon in clinical practice to see patients who were erroneously diagnosed as epileptic. Most of the time incorrect interpretation of EEG contributes significantly to this problem. In this study, we aimed to investigate the success rate of neurology residents in EEG interpretation after formal training. Eleven neurology residents were included in the study. Duration of EEG training (3 vs 4 months) and time since completion of EEG education were determined. Residents were randomly presented 30 different slides of representative EEG screenshots. They received 1 point for each correct response. The effect of training duration and time since training were investigated statistically. Besides, we looked at the success rate of each question to see whether certain patterns were more readily recognized than others. EEG training duration ( P = .93) and time since completion of training ( P = .16) did not influence the results. The success rate of residents for correct responses was between 17% and 50%. On the other hand, the success rate for each question varied between 0% and 91%. Overall, benign variants and focal ictal onset patterns were the most difficult to recognize. On 13 occasions (6.5%) nonepileptiform patterns were thought to represent epileptiform abnormalities. After formal training, neurology residents could identify ≤50% of the EEG patterns correctly. The wide variation in success rate among residents and also between questions implies that both personal characteristics and inherent EEG features influence successful EEG interpretation.

摘要

脑电图(EEG)是神经科医生用于癫痫诊断和分类的重要工具。在临床实践中,误被诊断为癫痫的患者并不少见。大多数情况下,脑电图解读错误是导致这一问题的重要原因。在本研究中,我们旨在调查经过正规培训的神经科住院医师解读脑电图的成功率。该研究纳入了11名神经科住院医师。确定了脑电图培训的时长(3个月与4个月)以及完成脑电图教育后的时间。向住院医师随机展示30张不同的具有代表性的脑电图截图幻灯片。他们每答对一题得1分。对培训时长和培训后的时间对结果的影响进行了统计学研究。此外,我们查看了每个问题的成功率,以了解某些模式是否比其他模式更容易识别。脑电图培训时长(P = 0.93)和培训结束后的时间(P = 0.16)并未影响结果。住院医师正确回答的成功率在17%至50%之间。另一方面,每个问题的成功率在0%至91%之间。总体而言,良性变异和局灶性发作起始模式最难识别。有13次(6.5%)非癫痫样模式被认为代表癫痫样异常。经过正规培训后,神经科住院医师能够正确识别的脑电图模式≤50%。住院医师之间以及问题之间成功率的广泛差异表明,个人特征和脑电图的固有特征都会影响脑电图解读的成功。

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