title: Prognostic Accuracy of Electroencephalograms in Preterm Infants: A Systematic Review.
abstract: BACKGROUND
  Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant.
  
  
  OBJECTIVE
  To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants for predicting neurodevelopmental outcome.
  
  
  METHODS
  The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature.
  
  
  METHODS
  We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported neurodevelopmental outcomes 1 to 10 years later.
  
  
  METHODS
  Two reviewers independently performed data extraction with regard to participants, prognostic testing, and outcomes.
  
  
  RESULTS
  Thirteen observational studies with a total of 1181 infants were included. A meta-analysis was performed based on 3 studies (267 infants). Any aEEG background abnormality was a predictor of abnormal outcome. For prediction of a developmental quotient <70 points, cerebral palsy, or death, the pooled sensitivity was 0.83 (95% confidence interval, 0.69-0.92) and specificity 0.83 (95% confidence interval, 0.77-0.87).
  
  
  CONCLUSIONS
  All studies were at high risk of bias. Heterogeneity was evident among the studies with regard to the investigated aEEG and EEG variables, neurodevelopmental outcomes, and cutoff values.
  
  
  CONCLUSIONS
  aEEG or EEG recorded within the first 7 days of life in preterm infants may have potential as a predictor for later neurodevelopmental outcome. We need high-quality studies to confirm these findings. Meanwhile, the prognostic value of aEEG and EEG should be used only as a scientific tool.
authors.affiliation: Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark empifo@gmail.com.
authors.forename: Emilie Pi
authors.initials: EP
authors.lastname: Fogtmann
authors.affiliation: Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Anne Mette
authors.initials: AM
authors.lastname: Plomgaard
authors.affiliation: Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.affiliation: The Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
mesh_terms: D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D001926:Brain Death; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D064887:Observational Studies as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted