PMID- 23747958
OWN - NLM
STAT- MEDLINE
DCOM- 20140623
LR  - 20130920
IS  - 1873-1570 (Electronic)
IS  - 0300-9572 (Linking)
VI  - 84
IP  - 10
DP  - 2013 Oct
TI  - Investigation of the inter-observer variability effect on the prognostic value of 
      somatosensory evoked potentials of the median nerve (SSEP) in cardiac arrest 
      survivors using an SSEP classification.
PG  - 1375-81
LID - S0300-9572(13)00297-9 [pii]
LID - 10.1016/j.resuscitation.2013.05.016 [doi]
AB  - BACKGROUND AND PURPOSE: We investigated the inter-observer variability in 
      interpretation of median nerve SSEPs with regard to neurological prognosis in 
      survivors of cardiac arrest (CA). METHODS: Four experienced neurologists analyzed 
      163 median nerve SSEPs on the basis of a pre-defined classification of SSEPs into 
      five patterns (A-E), with consideration of cortical potentials up to a latency of 
      150ms. Of these, 133 recordings were from CA survivors and 30 were from healthy 
      volunteers. The experts were blinded to whether a SSEP finding was from a CA 
      survivor or a healthy volunteer. They were also unaware of the neurological 
      outcome for the resuscitated patients. Three categories were defined for decision 
      making. These were "good neurological outcome" represented by patterns A-C, "poor 
      neurological outcome" (patterns D and E), and "not evaluable". Experts' agreement 
      was calculated using the kappa-coefficient. RESULTS: The mean correct prediction 
      by the experts was 81.8% (range 76.3-86.6%) in resuscitated patients with good 
      neurological outcome. In those with poor neurological outcome, however, correct 
      prediction was achieved in only 63% (60.5-66%). All SSEPs from healthy volunteers 
      were classified as "good neurological outcome". The kappa-coefficient (kappa) for all 
      decision-making classifications was 0.75; for patients with poor outcome it was 
      0.76 and for those with good outcome 0.88. The predictive value for poor 
      neurological outcome of the SSEP pattern D achieved a specificity of 93.5% and 
      that of E a specificity of 98.4%. CONCLUSION: Our study demonstrates good 
      inter-observer agreement in the interpretation of median nerve SSEPs in CA 
      survivors on the basis of a pre-defined SSEP evaluation set. The strongest 
      correlation with poor outcome was found for pattern E, bilateral absence of the 
      N20 peak.
CI  - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.
FAU - Pfeifer, Rudiger
AU  - Pfeifer R
AD  - Clinic of Internal Medicine I, University Hospital of Jena, Erlanger Allee 101, 
      Germany. Electronic address: Ruediger.Pfeifer@med.uni-jena.de.
FAU - Weitzel, Stephan
AU  - Weitzel S
FAU - Gunther, Albrecht
AU  - Gunther A
FAU - Berrouschot, Jorg
AU  - Berrouschot J
FAU - Fischer, Marius
AU  - Fischer M
FAU - Isenmann, Stefan
AU  - Isenmann S
FAU - Figulla, Hans R
AU  - Figulla HR
LA  - eng
PT  - Journal Article
DEP - 20130606
PL  - Ireland
TA  - Resuscitation
JT  - Resuscitation
JID - 0332173
SB  - IM
CIN - Resuscitation. 2013 Oct;84(10):1299. PMID: 23911629
MH  - Adult
MH  - *Evoked Potentials, Somatosensory
MH  - Female
MH  - Heart Arrest/*classification/*physiopathology
MH  - Humans
MH  - Male
MH  - Median Nerve/*physiopathology
MH  - Middle Aged
MH  - Observer Variation
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survivors
OTO - NOTNLM
OT  - CA
OT  - CPC
OT  - CPR
OT  - Cardiac arrest
OT  - Kappa-coefficient
OT  - Neurological outcome
OT  - Post anoxic coma
OT  - ROSC
OT  - SAPS II
OT  - SSEP
OT  - Somatosensory evoked potentials
OT  - cardiac arrest
OT  - cardiopulmonary resuscitation
OT  - cerebral performance category-scale
OT  - restoration of spontaneous circulation
OT  - simplified acute physiology score II
OT  - somatosensory evoked potentials of the median nerve
EDAT- 2013/06/12 06:00
MHDA- 2014/06/24 06:00
CRDT- 2013/06/11 06:00
PHST- 2012/10/16 00:00 [received]
PHST- 2013/05/21 00:00 [revised]
PHST- 2013/05/21 00:00 [accepted]
PHST- 2013/06/11 06:00 [entrez]
PHST- 2013/06/12 06:00 [pubmed]
PHST- 2014/06/24 06:00 [medline]
AID - S0300-9572(13)00297-9 [pii]
AID - 10.1016/j.resuscitation.2013.05.016 [doi]
PST - ppublish
SO  - Resuscitation. 2013 Oct;84(10):1375-81. doi: 10.1016/j.resuscitation.2013.05.016. 
      Epub 2013 Jun 6.