title: Improved multi-stage neonatal seizure detection using a heuristic classifier and a data-driven post-processor.
abstract: After identifying the most seizure-relevant characteristics by a previously developed heuristic classifier, a data-driven post-processor using a novel set of features is applied to improve the performance.
  
  
  
  The main characteristics of the outputs of the heuristic algorithm are extracted by five sets of features including synchronization, evolution, retention, segment, and signal features. Then, a support vector machine and a decision making layer remove the falsely detected segments.
  
  
  
  Four datasets including 71 neonates (1023h, 3493 seizures) recorded in two different university hospitals, are used to train and test the algorithm without removing the dubious seizures. The heuristic method resulted in a false alarm rate of 3.81 per hour and good detection rate of 88% on the entire test databases. The post-processor, effectively reduces the false alarm rate by 34% while the good detection rate decreases by 2%.
  
  
  
  This post-processing technique improves the performance of the heuristic algorithm. The structure of this post-processor is generic, improves our understanding of the core visually determined EEG features of neonatal seizures and is applicable for other neonatal seizure detectors.
  
  
  
  The post-processor significantly decreases the false alarm rate at the expense of a small reduction of the good detection rate.
authors.affiliation: Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium; iMinds Medical Information Technology, Leuven, Belgium. Electronic address: amirhossein.ansari@kuleuven.be.
authors.forename: A H
authors.initials: AH
authors.lastname: Ansari
authors.affiliation: Section of Clinical Neurophysiology, Department of Neurology, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Division of Neurology, Department of Medicine, McMaster University, Hamilton, Canada. Electronic address: perumpij@mcmaster.ca.
authors.forename: P J
authors.initials: PJ
authors.lastname: Cherian
authors.affiliation: Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven, Leuven, Belgium. Electronic address: anneleen.dereymaeker@uzleuven.be.
authors.forename: A
authors.initials: A
authors.lastname: Dereymaeker
authors.affiliation: Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium; iMinds Medical Information Technology, Leuven, Belgium. Electronic address: Vmatic@singidunum.ac.rs.
authors.forename: V
authors.initials: V
authors.lastname: Matic
authors.affiliation: Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven, Leuven, Belgium; Department of Development and Regeneration, University Hospitals Leuven, Child Neurology, KU Leuven, Leuven, Belgium. Electronic address: katrien.jansen@uzleuven.be.
authors.forename: K
authors.initials: K
authors.lastname: Jansen
authors.affiliation: Section of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Electronic address: a.dewispelaere@erasmusmc.nl.
authors.forename: L
authors.initials: L
authors.lastname: De Wispelaere
authors.affiliation: ZNA Koningin Paola Kinderziekenhuis, Antwerp, Belgium. Electronic address: charlotte.dielman@zna.be.
authors.forename: C
authors.initials: C
authors.lastname: Dielman
authors.affiliation: Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven, Leuven, Belgium. Electronic address: jan.vervisch@uzleuven.be.
authors.forename: J
authors.initials: J
authors.lastname: Vervisch
authors.affiliation: Section of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Electronic address: r.swarte@erasmusmc.nl.
authors.forename: R M
authors.initials: RM
authors.lastname: Swarte
authors.affiliation: Section of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center Rotterdam, The Netherlands; ZNA Koningin Paola Kinderziekenhuis, Antwerp, Belgium. Electronic address: govaert@icloud.com.
authors.forename: P
authors.initials: P
authors.lastname: Govaert
authors.affiliation: Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven, Leuven, Belgium. Electronic address: gunnar.naulaers@uzleuven.be.
authors.forename: G
authors.initials: G
authors.lastname: Naulaers
authors.affiliation: Institute of Biomedical Engineering, Department of Engineering, University of Oxford, Oxford, UK. Electronic address: maarten.devos@eng.ox.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: De Vos
authors.affiliation: Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium; iMinds Medical Information Technology, Leuven, Belgium. Electronic address: Sabine.VanHuffel@esat.kuleuven.be.
authors.forename: S
authors.initials: S
authors.lastname: Van Huffel
mesh_terms: D016208:Databases, Factual / Q000592:standards; D004569:Electroencephalography / Q000379:methods* / Q000592:standards; D000066506:Heuristics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology*; D060388:Support Vector Machine / Q000592:standards
keywords: Automated neonatal seizure detection; Hypoxic-ischemic encephalopathy; Machine learning; Support vector machines