Diagnostic accuracy of reduced electroencephalography montages for seizure detection: A frequentist and Bayesian meta-analysis.

IF 2.7 4区 医学 Q2 CLINICAL NEUROLOGY Neurophysiologie Clinique/Clinical Neurophysiology Pub Date : 2025-01-12 DOI:10.1016/j.neucli.2025.103044
Yu-Chen Lin, Hui-An Lin, Ming-Long Chang, Sheng-Feng Lin
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Abstract

Aim: To evaluate the diagnostic accuracy of reduced montage electroencephalography (EEG) for seizure detection and provide evidence-based recommendations.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a diagnostic meta-analysis to assess the sensitivity and specificity of reduced EEG montages in detecting seizure activity. A hierarchical summary receiver operating characteristic curve (HSROC) model was used to estimate the area under the curve (AUC). Subgroup analyses were conducted to identify sources of heterogeneity. Bayesian estimates were used for validation.

Results: Across 8 studies encompassing 3,458 reduced EEG montage samples, all studies used a reduced EEG montage with 7 to 10 electrodes. The pooled sensitivity was 0.75 (95 % CI: 0.68-0.80), and the pooled specificity was 0.97 (95 % CI: 0.95-0.98). The HSROC model had an AUC of 0.96 (95 % CI: 0.93-0.97). Variations in study results were attributed to factors such as the number of electrodes (pooled sensitivity of 0.66 for studies employing <8 leads and 0.77 for studies employing ≥8 leads) and montage design coverage (pooled sensitivity of 0.64 for studies employing subhairline montage and 0.77 for studies employing above-hairline montage). The Bayesian and frequentist findings agreed with each other and had a pooled sensitivity of 0.74 (95 % HPD: 0.65-0.83) and pooled specificity of 0.97 (95 % highest posterior density 0.95-0.98).

Conclusion: Reduced EEG montages with 8 or more electrodes are feasible for seizure detection, especially in emergency settings where rapid detection is crucial.

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减少脑电图蒙太奇对癫痫检测的诊断准确性:频率分析和贝叶斯荟萃分析。
目的:评价减蒙太奇脑电图(EEG)对癫痫发作的诊断准确性,并提出循证建议。方法:根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,我们进行了一项诊断性荟萃分析,以评估减少脑电图蒙太奇在检测癫痫发作活动方面的敏感性和特异性。采用分层汇总接收者工作特征曲线(HSROC)模型估计曲线下面积(AUC)。进行亚组分析以确定异质性的来源。使用贝叶斯估计进行验证。结果:在包含3,458个减少的EEG蒙太奇样本的8项研究中,所有研究都使用了7到10个电极的减少的EEG蒙太奇。合并敏感性为0.75 (95% CI: 0.68 ~ 0.80),合并特异性为0.97 (95% CI: 0.95 ~ 0.98)。HSROC模型的AUC为0.96 (95% CI: 0.93-0.97)。研究结果的差异归因于电极数量等因素(采用8个或更多电极的研究的总灵敏度为0.66)结论:减少EEG蒙太奇对癫痫发作检测是可行的,特别是在紧急情况下,快速检测是至关重要的。
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来源期刊
CiteScore
5.20
自引率
3.30%
发文量
55
审稿时长
60 days
期刊介绍: Neurophysiologie Clinique / Clinical Neurophysiology (NCCN) is the official organ of the French Society of Clinical Neurophysiology (SNCLF). This journal is published 6 times a year, and is aimed at an international readership, with articles written in English. These can take the form of original research papers, comprehensive review articles, viewpoints, short communications, technical notes, editorials or letters to the Editor. The theme is the neurophysiological investigation of central or peripheral nervous system or muscle in healthy humans or patients. The journal focuses on key areas of clinical neurophysiology: electro- or magneto-encephalography, evoked potentials of all modalities, electroneuromyography, sleep, pain, posture, balance, motor control, autonomic nervous system, cognition, invasive and non-invasive neuromodulation, signal processing, bio-engineering, functional imaging.
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