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Author Notes:

Correspondence: Jaden D. Barfuss, 50 Staniford St., Suite 401, Boston, MA 02114, USA.

Author contributions: Jaden D. Barfuss Massachusetts General Hospital, Boston, MA. Author Conceptualized and designed study, analyzed and interpreted data, drafted manuscript. Fábio A. Nascimento, MD Massachusetts General Hospital, Boston, MA. Author Conceptualized and designed study, analyzed and interpreted data, drafted manuscript. Erik Duhaime Centaur Labs, Boston, MA. Author Conceptualized and designed study, played a major role in acquisition of data, reviewed manuscript. Srishti Kapur Centaur Labs, Boston, MA. Author Conceptualized and designed study, played a major role in acquisition of data, reviewed manuscript. Loannis Karakis, MD Emory University School of Medicine, Atlanta, GA. Author Played a major role in creating gold standard. Marcus Ng, MD University of Manitoba, Winnipeg, MB, Canada. Author Played a major role in creating gold standard. Aline Heropian, MD Yale University, New Haven, CT. Author Played a major role in creating gold standard. Alice Lam, MD Massachusetts General Hospital, Boston, MA. Author Played a major role in creating gold standard. Douglas Maus, MD, PhD Massachusetts General Hospital, Boston, MA. Author Played a major role in creating gold standard. Jonathan J. Halford, MD Medical University of South Carolina, Charlestown, SC. Author Played a major role in creating gold standard. Sydney Cash, MD, PhD Massachusetts General Hospital, Boston, MA. Author Played a major role in creating gold standard. M. Brandon Westover, MD, PhD Massachusetts General Hospital, Boston, MA. Author Conceptualized and designed study, analyzed and interpreted data, reviewed manuscript, supervised study. Jin Jing, PhD Massachusetts General Hospital, Boston, MA. Author Conceptualized and designed study, analyzed and interpreted data, reviewed manuscript, supervised study.

Competing interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: E. Duhaime and S. Kapur of Centaur Labs developed and have a financial interest in the DiagnosUs app used to collect the data. J. Barfuss, F. Nascimento, I. Karakis, M. Ng, A. Herlopian, A. Lam, D. Maus, J. Halford, S. Cash, M. Westover, and J. Jing report no disclosures.

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Research Funding:

No funding was used in this study.

Keywords:

  • EEG
  • Epilepsy
  • Education
  • Interictal epileptiform discharges

On-demand EEG education through competition – A novel, app-based approach to learning to identify interictal epileptiform discharges

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Journal Title:

International Federation of Clinical Meurophysiology

Volume:

Volume 8

Publisher:

, Pages 177-186

Type of Work:

Article | Final Publisher PDF

Abstract:

Objective Misinterpretation of EEGs harms patients, yet few resources exist to help trainees practice interpreting EEGs. We therefore sought to evaluate a novel educational tool to teach trainees how to identify interictal epileptiform discharges (IEDs) on EEG. Methods We created a public EEG test within the iOS app DiagnosUs using a pool of 13,262 candidate IEDs. Users were shown a candidate IED on EEG and asked to rate it as epileptiform (IED) or not (non-IED). They were given immediate feedback based on a gold standard. Learning was analyzed using a parametric model. We additionally analyzed IED features that best correlated with expert ratings. Results Our analysis included 901 participants. Users achieved a mean improvement of 13% over 1,000 questions and an ending accuracy of 81%. Users and experts appeared to rely on a similar set of IED morphologic features when analyzing candidate IEDs. We additionally identified particular types of candidate EEGs that remained challenging for most users even after substantial practice. Conclusions Users improved in their ability to properly classify candidate IEDs through repeated exposure and immediate feedback. Significance This app-based learning activity has great potential to be an effective supplemental tool to teach neurology trainees how to accurately identify IEDs on EEG.

Copyright information:

© 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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