{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:30:50Z","timestamp":1790454650580,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013883","name":"LGS Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013883","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Identification of EEG waveforms is critical for diagnosing Lennox\u2013Gastaut Syndrome (LGS) but is complicated by the progressive nature of the disease. Here, we assess the interrater reliability (IRR) among pediatric epileptologists for classifying EEG waveforms associated with LGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A novel automated algorithm was used to objectively identify epochs of EEG with transient high power, which were termed events of interest (EOIs). The algorithm was applied to EEG from 20 LGS subjects and 20 healthy controls during NREM sleep, and 1350 EOIs were identified. Three raters independently reviewed the EOIs within isolated 15\u2010second EEG segments in a randomized, blinded fashion. For each EOI, the raters assigned a waveform label (spike and slow wave, generalized paroxysmal fast activity, seizure, spindle, vertex, muscle, artifact, nothing, or other) and indicated the perceived subject type (LGS or control).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Labeling of subject type had 85% accuracy across all EOIs and an IRR of \u03ba =0.790, suggesting that brief segments of EEG containing high\u2010power waveforms can be reliably classified as pathological or normal. Waveform labels were less consistent, with \u03ba =0.558, and the results were highly variable for different categories of waveforms. Label mismatches typically occurred when one reviewer selected \u201cnothing,\u201d suggesting that reviewers had different thresholds for applying named labels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Classification of EEG waveforms associated with LGS has weak IRR, due in part to varying thresholds applied during visual review. Computational methods to objectively define EEG biomarkers of LGS may improve IRR and aid clinical decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12858","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T07:53:43Z","timestamp":1698998023000},"page":"176-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Interrater reliability of interictal <scp>EEG<\/scp> waveforms in <scp>Lennox\u2013Gastaut<\/scp> Syndrome"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4720-2622","authenticated-orcid":false,"given":"Derek K.","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep","family":"Rana","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's Hospital Orange County  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Adams","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's Hospital Orange County  Orange California USA"},{"name":"Department of Pediatrics University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Do","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's Hospital Orange County  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Shrey","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's Hospital Orange County  Orange California USA"},{"name":"Department of Pediatrics University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6947-8852","authenticated-orcid":false,"given":"Shaun A.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4233-4802","authenticated-orcid":false,"given":"Beth A.","family":"Lopour","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of California  Irvine California 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