title: Effect of inpatient electroencephalography on clinical decision making.
abstract: BACKGROUND
  Routine inpatient electroencephalography (EEG) is commonly used as a diagnostic and therapeutic decision-making tool in the care of patients with a wide spectrum of conditions. Previous investigations on EEG use have focused on current guidelines or specific clinical presentations.
  
  
  OBJECTIVE
  To assess the effect of EEGs on clinical diagnosis and management of disease in adult inpatients in a community hospital.
  
  
  METHODS
  Medical records of adult patients who underwent EEG between October 2008 and June 2009 in a single general community hospital were retrospectively reviewed. Data were collected for comorbidities, diagnoses, and management. Findings from EEGs were classified as normal, abnormal, or uninterpretable and according to whether they resulted in a change in diagnosis or management, supported clinical decision making and resulted in no change in diagnosis or management, or did not contribute to diagnosis or management.
  
  
  RESULTS
  A total of 200 medical records were reviewed; 110 (55%) were for male patients and 90 (45%) were for female patients, with a mean (range) age of 60 (18-96) years. The most common pre-EEG diagnoses were altered mental status (52 [26%]) and seizure (48 [24%]). Of all EEGs, 115 (57.5%) had findings that were normal, 83 (41.5%) had findings that were abnormal, and 2 (1%) had findings that were uninterpretable. No EEGs had findings that resulted in a change in diagnosis or management, 8 EEGs (4%) had findings that supported clinical decision making and resulted in no change in diagnosis or management, and 192 EEGs (96%) had findings that did not contribute to diagnosis or management.
  
  
  CONCLUSIONS
  In this study, inpatient EEGs rarely contributed to clinical decision making and in no case resulted in a change in diagnosis or management. These findings warrant future research on the effectiveness of inpatient EEGs for a wide breadth of clinical inpatient diagnoses.
authors.affiliation: Department of Internal Medicine, TTUHSC-Permian Basin, 701 W 5th St, Odessa, TX 79763-4206. donald.loveman@ttuhsc.edu.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Harmon
authors.forename: Megan
authors.initials: M
authors.lastname: Craddock
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Jones
authors.forename: Craig W
authors.initials: CW
authors.lastname: Spellman
authors.forename: Donald M
authors.initials: DM
authors.lastname: Loveman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000175:diagnosis*; D006259:Craniocerebral Trauma / Q000175:diagnosis; D003661:Decision Support Techniques; D019468:Disease Management; D004569:Electroencephalography / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult