{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:50:35Z","timestamp":1785775835951,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Diagnostic and treatment delays in infantile epileptic spasms syndrome (IESS) increase the risk of poor neurodevelopmental outcomes. Early clinical recognition of IESS is essential, especially in regions lacking expedited access to electroencephalograms (EEG). This study aimed to determine clinicians' accuracy at recognizing infantile epileptic spasms (ES) based on smartphone videos, and the impact of brief IESS education on accuracy, diagnostic confidence, and willingness to treat without EEG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter prospective cohort study took place over seven sessions globally from 2022 to 2023. Smartphone videos of children from the US and South Africa with EEG\u2010confirmed diagnoses of IESS (6 videos) and non\u2010epileptic ES\u2010mimickers (3 videos) were obtained. Staff physicians and trainee participants from multiple subspecialties worldwide viewed videos three times: (1) baseline viewing, (2) after brief IESS training, and (3) with clinical history. Surveys on diagnosis and management were completed after each viewing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 187 participants who attended a session and initiated a survey, 180 (80 trainees [44%]) met the inclusion criteria. Initial diagnostic accuracy averaged 64% (95% confidence interval [CI]: 62\u201366%) and improved to 72% (69\u201374%) after IESS training and clinical history (V\u2009+\u2009T\u2009+\u2009CHx). Area under the curve for diagnostic performance of smartphone videos was 0.80 (0.78\u20130.82), and sensitivity was 0.85 (0.83\u20130.88) after V\u2009+\u2009T\u2009+\u2009CHx. The odds of making a correct diagnosis increased by 86% (OR 1.86, CI 1.59\u20132.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) after V\u2009+\u2009T\u2009+\u2009CHx. Diagnostic confidence and clinician comfort level treating ES without EEG also improved significantly after V\u2009+\u2009T\u2009+\u2009CHx (by 0.36 points and 0.45 points, respectively, on 5\u2010point Likert scales,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Diagnostic accuracy correlated strongly with increased diagnostic confidence and increased clinician comfort level managing patients without an EEG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Staff physicians had a 24% higher likelihood of making a correct diagnosis than trainees.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Smartphone videos, especially when enhanced by brief IESS training, can facilitate triage and early identification of infantile ES, reducing diagnostic delays in this time\u2010sensitive condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Infantile epileptic spasms syndrome is associated with severe developmental impacts, which can be worsened by delayed treatment. Rapid diagnosis is critical, especially in resource\u2010limited settings lacking specialists and timely access to diagnostic tests. Our study found that clinician participants identified epileptic spasms, the hallmark seizure type of this condition, based on video alone with moderately high accuracy, and accuracy improved after education and clinical information. Thus, smartphone videos, particularly when enhanced by brief training, may be an effective tool to triage movements concerning for epileptic spasms, potentially improving resource allocation and reducing diagnostic delays in this urgent childhood epilepsy condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70292","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T12:20:15Z","timestamp":1781266815000},"page":"1301-1313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone videos for infantile epileptic spasms triaging and assessment (\n                    <scp>VISTA<\/scp>\n                    study): Impact of education and standardized clinical history on diagnostic accuracy"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-0731","authenticated-orcid":false,"given":"Christine L.","family":"Shrock","sequence":"first","affiliation":[{"name":"Department of Neurology Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret C.","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Dartmouth Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Sham","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Paediatrics The Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cortina","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Center Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3287-3685","authenticated-orcid":false,"given":"Kathryn P.","family":"Gray","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Center Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Hsiu","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Systems Biology Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2918-3819","authenticated-orcid":false,"given":"Chahnez C.","family":"Triki","sequence":"additional","affiliation":[{"name":"Department of Child Neurology, LR19ES15 Neuropediatrie, Sfax Medical School University of Sfax  Sfax Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2242-8027","authenticated-orcid":false,"given":"Jacqueline","family":"French","sequence":"additional","affiliation":[{"name":"Department of Neurology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-4829","authenticated-orcid":false,"given":"J. Helen","family":"Cross","sequence":"additional","affiliation":[{"name":"UCL NIHR BRC Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-4632","authenticated-orcid":false,"given":"Orrin","family":"Devinsky","sequence":"additional","affiliation":[{"name":"Department of Neurology NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7328-1796","authenticated-orcid":false,"given":"Jo M.","family":"Wilmshurst","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1159-0128","authenticated-orcid":false,"given":"Archana A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"},{"name":"Department of Neurology, Division of Child Neurology Seattle Children's Hospital, University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"StatPearls [Internet]","author":"Smith MS","year":"2024"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awab162"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15433"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2011.03127.x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14205"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100040\u20101705121"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17239"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13057"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073820933739"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.02.035"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.08.009"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431\u2010012\u20101813\u20106"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1684\/epd.2021.1351"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2008.02.018"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2012.03.036"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.4785"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.107811"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17001"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.10.003"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2016.04.004"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010021\u201005040\u20105"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200117"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2011.07.004"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.2196\/11229"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2023.v113i1.16661"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429246593"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102105\u201012\u201077"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3762651"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002090"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2017.04.020"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.4103\/tjem.tjem_182_23"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1179\/1743132815Y.0000000009"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17112"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18090"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(24)00079\u20106"},{"key":"e_1_2_13_38_1","volume-title":"Intersectoral global action plan on epilepsy and other neurological disorders. 2022\u20132031","year":"2023"},{"key":"e_1_2_13_39_1","volume-title":"Mobile fact sheet","author":"Pew Research Center","year":"2024"},{"key":"e_1_2_13_40_1","volume-title":"Social media use continues to rise in developing countries, but plateaus across developed ones","author":"Poushter J","year":"2018"},{"key":"e_1_2_13_41_1","volume-title":"Atlas: country resources for neurologic disorders","year":"2017"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207633"},{"key":"e_1_2_13_42_2","doi-asserted-by":"crossref","unstructured":"Erratum in:Neurology. 2024 Mar 12;102(5):e208125.https:\/\/doi.org\/10.1212\/WNL.0000000000208125.","DOI":"10.1212\/WNL.0000000000208125"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70292","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi4.70292","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.70292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:16:57Z","timestamp":1785773817000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.70292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/epi4.70292"],"URL":"https:\/\/doi.org\/10.1002\/epi4.70292","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"assertion":[{"value":"2026-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}