Classification algorithms for the identification of structural injury in TBI using brain electrical activity.

Background: There is an urgent need for objective criteria adjunctive to standard clinical assessment of acute Traumatic Brain Injury (TBI). Details of the development of a quantitative index to identify structural brain injury based on brain electrical activity will be described.Methods: Acute clos...

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Publicado en:Computers in Biology & Medicine Vol. 53; pp. 125 - 134
Autores principales: Prichep, Leslie S, Ghosh Dastidar, Samanwoy, Jacquin, Arnaud, Koppes, William, Miller, Jonathan, Radman, Thomas, O'Neil, Brian, Naunheim, Rosanne, Huff, J Stephen
Formato: research Journal Article
Publicado: Elsevier B.V. Oct2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2014
      vid: 53
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      pub: Elsevier B.V.
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        10.1016/j.compbiomed.2014.07.011
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        atl: Classification algorithms for the identification of structural injury in TBI using brain electrical activity.
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          Prichep, Leslie S
          Ghosh Dastidar, Samanwoy
          Jacquin, Arnaud
          Koppes, William
          Miller, Jonathan
          Radman, Thomas
          O'Neil, Brian
          Naunheim, Rosanne
          Huff, J Stephen
        affil: Brain Research Laboratories, Department of Psychiatry, NYU School of Medicine, New York, NY, USA. Electronic address: Leslie.Prichep@nyumc.org.
      sug:
        subj:
          Classification Algorithms
          Brain Injuries Pathology
          Brain Injuries Physiopathology
          Diagnosis, Computer Assisted Methods
          Electroencephalography Methods
          Adolescence
          Adult
          Aged
          Aged, 80 and Over
          Brain Pathology
          Brain Physiopathology
          Female
          Human
          Male
          Middle Age
          Models, Statistical
          Tomography, X-Ray Computed
          Young Adult
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: There is an urgent need for objective criteria adjunctive to standard clinical assessment of acute Traumatic Brain Injury (TBI). Details of the development of a quantitative index to identify structural brain injury based on brain electrical activity will be described.Methods: Acute closed head injured and normal patients (n=1470) were recruited from 16 US Emergency Departments and evaluated using brain electrical activity (EEG) recorded from forehead electrodes. Patients had high GCS (median=15), and most presented with low suspicion of brain injury. Patients were divided into a CT positive (CT+) group and a group with CT negative findings or where CT scans were not ordered according to standard assessment (CT-/CT_NR). Three different classifier methodologies, Ensemble Harmony, Least Absolute Shrinkage and Selection Operator (LASSO), and Genetic Algorithm (GA), were utilized.Results: Similar performance accuracy was obtained for all three methodologies with an average sensitivity/specificity of 97.5%/59.5%, area under the curves (AUC) of 0.90 and average Negative Predictive Validity (NPV)>99%. Sensitivity was highest for CT+ cases with potentially life threatening hematomas, where two of three classifiers were 100%.Conclusion: Similar performance of these classifiers suggests that the optimal separation of the populations was obtained given the overlap of the underlying distributions of features of brain activity. High sensitivity to CT+ injuries (highest in hematomas) and specificity significantly higher than that obtained using ED guidelines for imaging, supports the enhanced clinical utility of this technology and suggests the potential role in the objective, rapid and more optimal triage of TBI patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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