Reliability in the assessment of paediatric somatosensory evoked potentials post cardiac arrest.

McDevitt, William M, Quinn, Laura, Bill, Peter R, Morris, Kevin P, Scholefield, Barnaby R and Seri, Stefano (2021) Reliability in the assessment of paediatric somatosensory evoked potentials post cardiac arrest. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 132 (3). pp. 765-769. ISSN 1872-8952. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

OBJECTIVE

To measure inter- and intra-rater agreement in the interpretation of cortical somatosensory evoked potential (SSEP) components following paediatric cardiac arrest (CA) in multi-professional neurophysiology teams.

METHODS

Thirteen professionals blinded to patient outcome interpreted 96 SSEPs in paediatric patients 24-/48-/72-hours following CA. Of these, 34 were duplicates used to assess intra-rater agreement. Consistent interpretations (absent/present/indeterminate) between scientists (who record/identify SSEP components) and neurophysiologists (who provide prognostic SSEP interpretation) were expressed as percentages. Rates of agreement were calculated using Fleiss' kappa coefficient (K).

RESULTS

Unanimous agreement between professionals was present in 40% (95%CI: 28-54%) of the interpreted SSEPs, with a K value of 0.62 (95%CI: 0.55-0.70) based on average agreement. Agreement was similar between neurophysiologists (K = 0.67; 95%CI: 0.57-0.77) and scientists (K = 0.62; 95%CI: 0.54-0.70) but lower in patients < 2 years old (K = 0.23; 95%CI: 0.14-0.33) and in those with poor outcome (K = 0.21; 95%CI: 0.07-0.35). No SSEP was unanimously interpreted as absent and 92% (95%CI: 89-95%) of duplicate SSEPs were interpreted consistently.

CONCLUSION

Despite substantial agreement when interpreting prognostic SSEPs, this was significantly lower in children with poor outcome and of younger age.

SIGNIFICANCE

Clinicians using SSEPs in the intensive care unit should be aware of the inter-rater variability when interpreting SSEPs as absent.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QA Mathematics. Computing
WG Cardiovascular system. Cardiology
WS Paediatrics. Child health
Divisions: Clinical Support
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Depositing User: Mrs Yolande Brookes
Date Deposited: 12 Feb 2021 16:47
Last Modified: 12 Feb 2021 16:47
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3971

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