LAUSR

ABSTRACT Objectives EEG technologists commonly screen continuous EEG. Until now, the interrater agreement or sensitivity for important EEG findings has been unknown in this group. Methods Twenty-nine EEG technologists and three clinical neurophysiologists interpreted 90 five-minute samples of pediatric critical care EEG. Interrater agreement was examined with Cohen’s kappa and Fleiss’ kappa for EEG findings. A gold-standard consensus agreement was developed for examining sensitivity and specificity for seizures or discontinuity. Kruskal-Wallis tests with Benjamani-Hochberg corrections for multiple comparisons was utilized to examine associations between correct scoring and certification status and years of experience. Results Aggregate agreement was moderate for seizures and fair for EEG background continuity among EEG technologists. Individual agreement for seizures and continuity varied from slight to substantial. For individual EEG technologists, sensitivity for seizures ranged from 44-93% and sensitivity for continuity ranged from 81-100%. Raters with Certified Long Term Monitoring credentials were more likely to identify seizures correctly. Significance This is the first published study evaluating interrater agreement and interpretation correctness among EEG technologists interpreting pediatric CCEEG. EEG technologists demonstrated better aggregate agreement for seizure detection than other EEG findings, yet individual results and internal consistency varied widely. These data provide important insight into the common practice of utilizing EEG technologists for screening CCEEG.