Assessment of a scalp EEG-based automated seizure detection system

Objective: The purpose of this study was to evaluate and validate an offline, automated scalp EEG-based seizure detection system and to compare its performance to commercially available seizure detection software. Methods: The test seizure detection system, IdentEvent (TM), was developed to enhance the efficiency of post-hoc long-term EEG review in epilepsy monitoring units. It translates multi-channel scalp EEG signals into multiple EEG descriptors and recognizes ictal EEG patterns. Detection criteria and thresholds were optimized in 47 long-term scalp EEG recordings selected for training (47 subjects, similar to 3653 h with 141 seizures). The detection performance of IdentEvent was evaluated using a separate test dataset consisting of 436 EEG segments obtained from 55 subjects (similar to 1200 h with 146 seizures). Each of the test EEG segments was reviewed by three independent epileptologists and the presence or absence of seizures in each epoch was determined by majority rule. Seizure detection sensitivity and false detection rate were calculated for IdentEvent as well as for the comparable detection software (Persyst's Reveal (R), version 2008.03.13, with three parameter settings). Bootstrap re-sampling was applied to establish the 95% confidence intervals of the estimates and for the performance comparison between two detection algorithms. Results: The overall detection sensitivity of IdentEvent was 79.5% with a false detection rate (FDR) of 2 per 24 h, whereas the comparison system had 80.8%, 76%, and 74% sensitivity using its three detection thresholds (perception score) with FDRs of 13, 8, and 6 per 24 h, respectively. Bootstrap 95% confidence intervals of the performance difference revealed that the two detection systems had comparable detection sensitivity, but IdentEvent generated a significantly (p < 0.05) smaller FDR. Conclusions: The study validates the performance of the IdentEvent (TM) seizure detection system. Significance: With comparable detection sensitivity, an improved false detection rate makes the automated seizure detection software more useful in clinical practice. (C) 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.