Clinical validation of autoSCORE: A human-in-the-loop AI tool for interpretation of long-term EEG recordings.
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Tveit Jesper, Aurlien Harald, Husain Aatif M, Tarazi Apameh, Diehl Beate, Gallentine William, Tatum William O, Hahn Cecil D, Schulze Daniel Gregor, Terney Daniella, Schomer Donald L, Aanestad Eivind, Gardella Elena, Westhall Erik, Gonzalez-Giraldo Ernesto, Catenaccio Eva, Cox Fieke, Fahoum Firas, Tankisi Hatice, Hjelland Ina, Brøgger Jan, Hébert Julien, Xiong Katherine, Nilsen Kristian Bernhard, Goldstein Lilach, Ulvin Line, Henning Oliver Johannes, Kaplan Peter W, Omland Petter, Pearl Phillip L, Arya Ravindra, Wennberg Richard, Markhus Rune, Massey Shavonne L, Schuele Stephan, Kessler Sudha Kilaru, Pang Trudy, Frauscher Birgit, Beniczky Sándor
Аннотация
METHODS: autoSCORE automatically divides LT-EEG into 2-hour segments, labeling each as normal or as containing one or more of four abnormality categories: focal epileptiform, generalized epileptiform, focal non-epileptiform, or diffuse non-epileptiform. In abnormal segments, it also inserts markers defined by start/stop times and tagged by abnormality type. Within each category, markers can be ranked by decreasing probability. Eighty 2-hour LT-EEG segments (40 in-hospital, 40 ambulatory) from patients aged 0.9-82.3 years were analyzed by autoSCORE. The diagnostic reference standard was derived from independent conventional visual assessment by three human experts.
RESULTS: Accuracy computed across expert-expert and AI-expert pairings, evaluated at the level of the 2-hour segments, were comparable, except for detection of focal non-epilepiform abnormality, where AI outperformed experts for identification accuracy (p = 0.019). The positive predictive value of the automated abnormality markers was 0.446-0.823. In the human-in-the-loop workflow, inspecting 10 automated markers with the highest probability in each category enabled correct identification of all abnormal segments, corresponding to 1.5%-5.5% of the full 2-hour segment.
CONCLUSIONS: autoSCORE accurately screens LT-EEG recordings and may serve as an adjunct to human EEG interpretation to reduce the workload of human experts.
SIGNIFICANCE: autoSCORE is a validated tool that can increase the productivity and efficacy of human experts in assessment of LT-EEG to improve patient diagnosis and management strategies.