Faculty of Medicine/UZ Leuven, KU Leuven, Leuven, Belgium.
Laboratory for Epilepsy Research, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Acta Neurol Belg. 2020 Dec;120(6):1271-1281. doi: 10.1007/s13760-020-01417-z. Epub 2020 Jul 6.
Epilepsy affects 50 million patients and their caregivers worldwide. Devices that facilitate the detection of seizures can have a large influence on a patient's quality of life, therapeutic decisions and the conduct of clinical trials with anti-epileptic drugs. This article provides an up-to-date overview and comparison between wearable seizure detection devices (WSDDs), taking into account the newly proposed standards for testing and clinical validation of devices. 16 devices were included in our comparison. The F1-score, combining the device's accurate recall and precision, was calculated for each of these devices and used to evaluate their performance. The devices were separated by development phase and ranked by F1-score from highest to lowest. We describe 16 WSDDs: 6 of which were accelerometry (ACM)-based, 3 surface electromyography-based, 1 was a wearable application of EEG, 4 had multimodal sensors and 2 other types of sensors. We observed a significant inconsistency in the description of performance measures. The devices in the most advanced development phase with the highest F1-scores incorporated ACM- and sEMG-based sensors to detect tonic-clonic seizures. This review highlights the importance of implementing standards for an optimal comparison and, therefore, improving the research and development of WSDDs. WSDDs can improve the patient's care and quality of life, decrease seizure underreporting and they could potentially prevent sudden-unexpected-death in epilepsy. We discuss the central role of the neurologist in the use of WSDDs, and why a business to business to consumer model is better than the current business to consumer model of most WSDDs.
癫痫影响着全球 5000 万患者及其照护者。有助于检测癫痫发作的设备可以对患者的生活质量、治疗决策以及抗癫痫药物的临床试验产生重大影响。本文考虑到新提出的设备测试和临床验证标准，对可穿戴式癫痫检测设备（WSDD）进行了最新的综述和比较。我们的比较纳入了 16 种设备。对这些设备中的每一种，我们都计算了设备的准确召回率和精确率的 F1 分数，并用其来评估性能。根据 F1 分数，将设备按开发阶段进行分组，从高到低进行排名。我们描述了 16 种 WSDD：其中 6 种基于加速度计（ACM），3 种基于表面肌电图（sEMG），1 种是 EEG 的可穿戴应用，4 种具有多模态传感器，2 种其他类型的传感器。我们观察到对性能测量描述的显著不一致。处于最先进开发阶段且 F1 分数最高的设备采用 ACM 和 sEMG 传感器来检测强直阵挛性发作。这篇综述强调了实施标准进行优化比较的重要性，从而改善 WSDD 的研究和开发。WSDD 可以改善患者的护理和生活质量，减少癫痫发作漏报，并且有可能预防癫痫患者的突发意外死亡。我们讨论了神经病学家在使用 WSDD 方面的核心作用，以及为什么企业对企业对消费者的模式优于大多数 WSDD 目前的企业对消费者模式。
