American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2021 Version

• Type of Material: Article
• Authors: Suzette Laroche, Emory University; Lawrence J Hirsch, Yale University; Michael WK Fong, University of Sydney; Markus Leitinger, Paracelsus Med Univ; Suzette M LaRoche, Emory University; Sandor Beniczky, Dianalund and Aarhus University Hospital; Nicholas S Abend, University of Pennsylvania; Jong Woo Lee, Brigham and Women’s Hospital; Courtney J Wusthoff, Stanford University; Cecil D Hahn, University of Toronto; Brandon M Westover, Massachusetts General Hospital; Elizabeth E Gerard, Northwestern University; Susan T Herman, Barrow Neurological Institute; Hiba Haider, Emory University; Gamaleldin Osman, Henry Ford Hospital; Andres Rodriguez Ruiz, Emory University; Carolina B Maciel, University of Florida; Emily J Gilmore, Yale University; Andres Fernandez, Thomas Jefferson University Hospital; Eric S Rosenthal, Harvard Medical School; Jan Claassen, Columbia University; Aatif M Husain, Duke University; Ji Yeoun Yoo, Icahn School of Medicine at Mount Sinai; Elson L So, Mayo Clinic; Peter W Kaplan, Johns Hopkins University; Marc R Nuwer, University of California Los Angeles; Michel van Putten, Medical Spectrum Twente; Raoul Sutter, University Hospital Basel; Frank W Drislane, Harvard Medical School; Eugen Trinka, Paracelsus Medical University; Nicolas Gaspard, Université Libre de Bruxelles
• Language: English
• Date: 2021-01-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 by the American Clinical Neurophysiology Society
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/WNP.0000000000000806
• Title of Journal or Parent Work: JOURNAL OF CLINICAL NEUROPHYSIOLOGY
• Volume: 38
• Issue: 1
• Start Page: 1
• End Page: 29
• Keywords: ADULTS; Science & Technology; INTERRATER AGREEMENT; Life Sciences & Biomedicine; BURSTS; ICTAL RHYTHMIC DISCHARGES; SEIZURE BURDEN; Neurosciences & Neurology; PATTERNS; CRITERIA; Neurosciences; Clinical Neurology

Abstract

In the early 2000s, a subcommittee of the American Clinical Neurophysiology Society (ACNS) set out to “standardize terminology of periodic and rhythmic EEG patterns in the critically ill to aid in future research involving such patterns.” The initial proposed terminology was published in 2005.1 This was presented at many meetings on several continents, subjected to multiple rounds of testing of interrater reliability, underwent many revisions, and was then published as an ACNS guideline in 2013.2 Interrater agreement of the 2012 version (published in early 2013) was very good, with almost perfect agreement for seizures, main terms 1 and 2, the +S modifier, sharpness, absolute amplitude, frequency, and number of phases.3 Agreement was substantial for the +F and +R modifiers (66% and 67%) but was only moderate for triphasic morphology (58%) and fair for evolution (21%, likely at least partly because of the short EEG samples provided).3 The authors concluded that interrater agreement for most terms in the ACNS critical care EEG terminology was high and that these terms were suitable for multicenter research on the clinical significance of these critical care EEG patterns.