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OBJECTIVES: To evaluate the inter- and intra-rater reliability for the identification of bad channels among neurologists, EEG Technologists, and naïve research personnel, and to compare their performance with the automated bad channel detection (ABCD) algorithm for detecting bad channels. Methods: Six Neurologists, ten EEG Technologists, and six naïve research personnel (22 raters in total) were asked to rate 1440 real intracranial EEG channels as good or bad. Intra- and interrater kappa statistics were calculated for each group. We then compared each group to the ABCD algorithm which uses spectral and temporal domain features to classify channels as good or bad. Results: Analysis of channel ratings from our participants revealed variable intra-rater reliability within each group, with no significant differences across groups. Inter-rater reliability was moderate among neurologists and EEG Technologists but minimal among naïve participants. Neurologists demonstrated a slightly higher consistency in ratings than EEG Technologists. Both groups occasionally misclassified flat channels, and participants generally focused on low-frequency content for their assessments. The ABCD algorithm, in contrast, relied more on high-frequency content. A logistic regression model showed a linear relationship between the algorithm's ratings and user responses for predominantly good channels, but less so for channels rated as bad. Sensitivity and specificity analyses further highlighted differences in rating patterns among the groups, with neurologists showing higher sensitivity and naïve personnel higher specificity. Significance: Our study reveals the bias in human assessments of iEEG data quality and the tendency of even experienced professionals to overlook certain bad channels, highlighting the need for standardized, unbiased methods. The ABCD algorithm, outperforming human raters, suggests the potential of automated solutions for more reliable iEEG interpretation and seizure characterization, offering a reliable approach free from human biases. .
RESUMO
BACKGROUND: Venous thromboembolism (VTE) remains the single most important preventable cause of morbidity and mortality following neurosurgical procedures, with an incidence of approximately 16%. In the absence of stringent guidelines, the variation in current practice patterns could be considerable and was the underlying basis for this study. OBJECTIVES: Our objective is to evaluate the modality of thromboprophylaxis used by neurosurgeons. METHODS: In line with "CHERRIES" (Checklist for Reporting Results of Internet E-Surveys) guidelines, an online survey regarding postoperative VTE prophylaxis following elective neurosurgical procedures was created using Google Forms and distributed to 1500 board-certified neurosurgeons in the United States. RESULTS: A total of 370 board-certified neurosurgeons (24.7%) responded to the survey. Sequential compression device was the only primary method of thromboprophylaxis used by 27.2% and 26.5% of respondents after elective craniotomy for tumor resection and spine surgery, respectively. Of the chemical prophylaxis, subcutaneous heparin 5000 U every 8 hours was the most commonly used medication followed by enoxaparin 40 mg daily. Most responders were comfortable starting chemical prophylaxis on postoperative day 1, followed by day 2 and day 3 in both types of surgeries. The mean postoperative time of chemical prophylaxis initiation was significantly more delayed by respondents with longer years in practice. CONCLUSIONS: This study highlights the variation in practice between neurosurgeons in managing postoperative VTE prophylaxis after elective spine and cranial surgeries. In lieu of this variation, our results showed that most neurosurgeons are comfortable starting chemical prophylaxis as soon as postoperative day 1 following both types of procedures.
