Impact of standardized electroencephalography terminology education among early-career neurologists in Korea: a single-group pretest-posttest study.

Kyung-Il Park, Sang Bin Hong, Hansang Lee
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Abstract

Purpose: This study evaluated the effectiveness of implementing standardized electroencephalography (EEG) terminology and education on improving interpretation skills among non-English speakers.

Methods: EEGs were collected retrospectively from 16 critically ill patients and two alert epilepsy patients (30-minute sessions) and read by 10 neurologists. After initial interpretation, a learning module was provided to the neurologists. One week later, the neurologists reinterpreted the same EEGs randomly reordered. The interpretation accuracies of 144 items were scored as correct, similar, incorrect, or not recognized based on consensus answers.

Results: Overall scores improved significantly after learning modules were completed, increasing from 88.8 ± 23.1 to 118.2 ± 39.2 (p = 0.037). Performance improvement was also observed, regardless of years of clinical experience treating patients with epilepsy. However, more experienced raters tended to have higher inter-rater agreement. The baseline correct answer rates for rhythmic delta activity (RDA), periodic discharges (PD), sporadic epileptiform discharge (ED), and electrographic seizures (ES) were 42.5%, 50%, 60.0%, and 20.0%, respectively. After the learning modules were completed, correct answer rates increased by 21.4% for RDA (p = 0.11), 11.1% for PD (p = 0.06), and 28.1% for ES (p = 0.02), but decreased by 11.1% for sporadic ED (p = 0.02). Specifically, the accuracy for generalized PD improved significantly after learning (p = 0.04). Most minor items except location were often missed even after learning.

Conclusion: Education is imperative for standardizing EEG descriptions. As such, developing educational modules that emphasize minor items including prevalence, frequency, duration, and amplitude will broaden the recognition of EEG features, improving the quality of future research and patient care.

标准化脑电图术语教育对韩国早期职业神经科医生的影响:一项单组前测后测研究。
目的:本研究评估实施标准化脑电图(EEG)术语和教育对提高非英语母语者口译技能的有效性。方法:回顾性收集16例危重症患者和2例危重性癫痫患者的脑电图(每30分钟一次),由10名神经科医师阅读。在初步解读后,向神经科医生提供了一个学习模块。一周后,神经学家重新解释了随机排列的相同的脑电图。144个项目的解释准确性根据共识答案分为正确、相似、不正确或未被识别。结果:完成学习模块后,总分由88.8±23.1分提高至118.2±39.2分(p = 0.037)。与治疗癫痫患者多年的临床经验无关,也观察到表现的改善。然而,更有经验的评分者往往有更高的评分者之间的一致性。节律性delta活动(RDA)、周期性放电(PD)、散发性癫痫样放电(ED)和电性癫痫发作(ES)的基线正确率分别为42.5%、50%、60.0%和20.0%。学习模块完成后,RDA的正确率提高了21.4% (p = 0.11), PD的正确率提高了11.1% (p = 0.06), ES的正确率提高了28.1% (p = 0.02),而零星ED的正确率下降了11.1% (p = 0.02)。学习后,广义PD的准确率显著提高(p = 0.04)。除了位置以外,大部分的小项目在学习之后也经常被遗漏。结论:教育是规范脑电描述的必要条件。因此,开发强调流行率、频率、持续时间和振幅等次要项目的教育模块,将扩大对脑电图特征的认识,提高未来研究和患者护理的质量。
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