Intra and inter-observer reliability of electroencephalogram interpretation in pediatric patients with neurological alterations
Main Article Content
Keywords
Electroencephalography, Observer variation, Epilepsy, Diagnosis, Pediatrics
Abstract
Introduction: Interpreting an electroencephalogram (EEG) is a subjective process which involves various obstacles to reach an agreement. If the interobserver agreement of a diagnostic process is poor, that process cannot be considered accurate. The aim of this study was to evaluate the intra and interobserver agreement of the EEG reading in pediatric patients.
Methods: 108 EEGs of children under 16 years of age were included. EEGs were interpreted by two pediatric neurologists. Observer number one performed three readings on three different moments to assess intraobserver agreement, while the third reading was blind for the diagnosis. Interobserver agreement was assessed with a single blind reading for the diagnosis of the two observers. Agreement was measured with the kappa index.
Results: Intraobserver agreement to differentiate if the EEG was normal or abnormal was substantial when the three readings were compared (kappa index: 0.66-0.78). The highest agreement rate corresponded to the readings of those who had knowledge of the diagnosis. The interobserver agreement assessing between abnormal or normal EEG was slight (k = 0.12).
Conclusions: Since the EEG is a subjective interpreter dependent study, it is necessary to establish a consensus to standardize the criteria for its interpretation in order to increase the interobserver agreement.
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