Interrater reliability of EEG-video monitoring  

Oleh:

Benbadis, S. R. ; Papandonatos, G. D. ; Korabathina, K. ; Lin, K.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Neurology (Official Journal of The American Academy of Neurology) vol. 73 no. 11 (Sep. 2009), page 843-846.
Topik: PSYCHOGENIC NONEPILEPTIC SEIZURES; PARASOMNIAS

Ketersediaan

Perpustakaan FK Nomor Panggil: N11.K.2009.06 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective: The diagnosis of psychogenic nonepileptic seizures (PNES) can be challenging. In the absence of a gold standard to verify the reliability of the diagnosis by EEG-video, we sought to assess the interrater reliability of the diagnosis using EEG-video recordings. Methods: Patient samples consisted of 22 unselected consecutive patients who underwent EEG-video monitoring and had at least an episode recorded. Other test results and histories were not provided because the goal was to assess the reliability of the EEG-video. Data were sent to 22 reviewers, who were board-certified neurologists and practicing epileptologists at epilepsy centers. Choices were 1) PNES, 2) epilepsy, and 3) nonepileptic but not psychogenic ("physiologic") events. Interrater agreement was measured using a {kappa} coefficient for each diagnostic category. We used generalized {kappa} coefficients, which measure the overall level of between-method agreement beyond that which can be ascribed to chance. We also report category-specific {kappa} values. Results: For the diagnosis of PNES, there was moderate agreement ({kappa} = 0.57, 95% confidence interval [CI] 0.39–0.76). For the diagnosis of epilepsy, there was substantial agreement ({kappa} = 0.69, 95% CI 0.51–0.86). For physiologic nonepileptic episodes, the agreement was low ({kappa} = 0.09, 95% CI 0.02–0.27). The overall {kappa} statistic across all 3 diagnostic categories was moderate at 0.56 (95% CI 0.41–0.73). Conclusions: Interrater reliability for the diagnosis of psychogenic nonepileptic seizures by EEG-video monitoring was only moderate. Although this may be related to limitations of the study (diagnosis based on EEG-video alone, artificial nature of the forced choice paradigm, single episode), it highlights the difficulties and subjective components inherent to this diagnosis.

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