Krystal A D, Weiner R D
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
Convuls Ther. 1995 Sep;11(3):158-69.
Reliable monitoring of electroencephalographic (EEG) and electromyographic electroconvulsive therapy (ECT) seizure duration has become important as these assessments have become a routine part of the clinical practice of ECT. In this regard, accurate automated seizure duration determinations would be particularly valuable. As a result, the present study was performed to assess the reliability of available computer-automated determinations of seizure duration (Thymatron Model DGx ECT machine; Somatics, Inc.) and to explore the factors upon which such reliability as well as the determinations of experienced raters depend. We found that the experienced human raters had very high interrater reliability, significantly higher than either did with the automated Thymatron DGx ratings. In general, the reliability of all ratings declined in the context of artifact, poor postictal suppression, or an EEG seizure end point that was reached gradually. Reliability was also greater for continuation ECT as compared with the index course. The reliability of Thymatron DGx versus experienced human ratings was particularly sensitive to these factors, ranging from 0.68 when several of these factors were simultaneously present to 0.999 when all these factors were absent.
随着脑电图（EEG）和肌电图在电休克治疗（ECT）中对发作持续时间的监测已成为临床实践的常规部分，可靠地监测这些发作持续时间变得愈发重要。在这方面，准确的自动发作持续时间测定将特别有价值。因此，本研究旨在评估现有的计算机自动测定发作持续时间（Thymatron Model DGx ECT机器；Somatics公司）的可靠性，并探讨这种可靠性以及经验丰富的评估者的测定所依赖的因素。我们发现，经验丰富的人工评估者具有非常高的评估者间可靠性，显著高于自动Thymatron DGx评分。总体而言，在存在伪迹、发作后抑制不佳或EEG发作终点逐渐达到的情况下，所有评分的可靠性都会下降。与首次疗程相比，维持ECT的可靠性也更高。Thymatron DGx评分与经验丰富的人工评分的可靠性对这些因素特别敏感，当同时存在其中几个因素时为0.68，而当所有这些因素都不存在时为0.999。
