title: Diagnostic accuracy of microEEG: a miniature, wireless EEG device.
abstract: Measuring the diagnostic accuracy (DA) of an EEG device is unconventional and complicated by imperfect interrater reliability. We sought to compare the DA of a miniature, wireless, battery-powered EEG device ("microEEG") to a reference EEG machine in emergency department (ED) patients with altered mental status (AMS). Two hundred twenty-five ED patients with AMS underwent 3 EEGs. Two EEGs, EEG1 (Nicolet Monitor, "reference") and EEG2 (microEEG) were recorded simultaneously with EEG cup electrodes using a signal splitter. The remaining study, EEG3, was recorded with microEEG using an electrode cap immediately before or after EEG1/EEG2. The official EEG1 interpretation was considered the gold standard (EEG1-GS). EEG1, 2, and 3 were de-identified and blindly interpreted by two independent readers. A generalized mixed linear model was used to estimate the sensitivity and specificity of these interpretations relative to EEG1-GS and to compute a diagnostic odds ratio (DOR). Seventy-nine percent of EEG1-GS were abnormal. Neither the DOR nor the κf representing interrater reliabilities differed significantly between EEG1, EEG2, and EEG3. The mean setup time was 27 min for EEG1/EEG2 and 12 min for EEG3. The mean electrode impedance of EEG3 recordings was 12.6 kΩ (SD: 31.9 kΩ). The diagnostic accuracy of microEEG was comparable to that of the reference system and was not reduced when the EEG electrodes had high and unbalanced impedances. A common practice with many scientific instruments, measurement of EEG device DA provides an independent and quantitative assessment of device performance.
authors.affiliation: Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA; Department of Physiology and Pharmacology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA. Electronic address: arthur.grant@downstate.edu.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Grant
authors.affiliation: Bio-Signal Group Corporation, Brooklyn, NY 11226, USA.
authors.forename: Samah G
authors.initials: SG
authors.lastname: Abdel-Baki
authors.affiliation: Bio-Signal Group Corporation, Brooklyn, NY 11226, USA.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Omurtag
authors.affiliation: Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Sinert
authors.affiliation: Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Geetha
authors.initials: G
authors.lastname: Chari
authors.affiliation: Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Schweta
authors.initials: S
authors.lastname: Malhotra
authors.affiliation: The Scientific Computing Center, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Weedon
authors.affiliation: Department of Physiology and Pharmacology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA; Center for Neural Science, New York University, New York, NY 10003, USA.
authors.forename: Andre A
authors.initials: AA
authors.lastname: Fenton
authors.affiliation: Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Zehtabchi
mesh_terms: D004569:Electroencephalography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012640:Seizures / Q000175:diagnosis*; D012680:Sensitivity and Specificity
keywords: Altered mental status; Diagnostic accuracy; EEG; Sensitivity and specificity
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