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#Eeg reading free
To mimic standard EEG interpretation conditions, readers were free to adjust the montage, voltage sensitivity, time base, and frequency filters. They were unaware of indication for the EEG, patient history, and technologist comments. Readers were aware of only patient age and medications, making interpretation more difficult than in routine clinical practice. These important limitations in the accuracy of EEG interpretation are not addressed in EEG textbooks, possibly because expert EEG interpreters paradoxically have very high confidence in their interpretations, a surprisingly common circumstance in clinical medicine. Similarly, most studies have measured I&IR of detecting specific findings such as seizures or interictal epileptiform discharges, rather than of interpreting the EEG into standard diagnostic categories (e.g. Few research studies have examined EEG I&IR based on interpretation of complete EEGs rather than short segments. Over 50 years of research has consistently shown that EEG I&IR, when measured with the kappa statistic, ranges from slight to substantial depending on the specific EEG finding or interpretive category being examined ( Table 1). If interpreters do not agree with themselves when re-reading a study, or with each other when reading the same study, then at least some interpretations must be wrong. A necessary, though insufficient, condition for accurate EEG interpretation is high intrarater and interrater reliability (I&IR) among interpreters. While EEG findings are described with a standardized terminology, the skill of EEG interpretation is learned primarily in a master-apprentice format. There is no gold standard for an EEG’s true interpretation. This goal could be accomplished, for instance, with an automated on-line application integrated into a continuing medical education module that measures and reports EEG I&IR to individual users. A necessary but insufficient condition to improve EEG interpretation accuracy is to increase intrarater and interrater reliability. Experienced epileptologists have very high confidence in their EEG interpretations and low to moderate I&IR, a common paradox in clinical medicine. EEGs) was 65.3%, to readers was 3.9%, and to the interaction between readers and subjects was 30.8%. The κ c were not significantly different across rater pairs (Chi-Square = 17.3, df=14, p = 0.24). κ c ranged from 0.29 to 0.62 for the 15 reader pairs, with an aggregated Fleiss kappa of 0.44 for interrater agreement. Intrarater Cohen’s kappa (κ c) ranged from 0.33 to 0.73 with an aggregated value of 0.59.
![eeg reading eeg reading](https://mne.tools/stable/_images/sphx_glr_read_xdf_001.png)
Five of the six readers had a median confidence of ≥ 99%, and the upper quartile of confidence values was 100% for all six readers. A generalizability study assessed the contribution of subjects, readers, and the interaction between subjects and readers to interpretation variance. Each reader interpreted 150 unique studies, and 50 studies twice to generate intrarater data.
![eeg reading eeg reading](https://d3i71xaburhd42.cloudfront.net/30a99754b6e2f427154fb4ec954f7dab642f9151/4-Figure2-1.png)
During two distinct time intervals six board-certified clinical neurophysiologists classified 300 EEGs into one or more of seven diagnostic categories, and assigned a subjective confidence to their interpretations. We measured both I&IR of EEG interpretation based on interpretation of complete EEGs into standard diagnostic categories and rater confidence in their interpretations, and investigated sources of variance in EEG interpretations. The intrarater and interrater reliability (I&IR) of EEG interpretation has significant implications for the value of EEG as a diagnostic tool.