{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:13:28Z","timestamp":1788776008301,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"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":["Pediatric Anesthesia"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Procedural sedation is often essential for children undergoing imaging examinations. Whether the wavelet index (WLI) could outperform Ramsay Sedation Score (RS) in assessing sedation depth and identifying children at risk of MRI sedation failure was unknown.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This prospective, single\u2010blind study was performed at a tertiary care hospital. WLI and RS were measured in 74 pediatric patients who underwent MRI scanning after procedural sedation with chloral hydrate and dexmedetomidine. Once the patient reached RS scores 5 or 6, the MRI examination was initiated. Successful MRI sedation was defined as completion of the planned MRI examination at the first attempt with no clinically significant motion artifact and no need for additional rescue sedation or conversion to general anesthesia.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sixty\u2010five children successfully completed the MRI examination, and nine failed due to insufficient sedation. The AUC for WLI was 0.902 (95% CI, 0.814\u20130.990) versus 0.734 (95% CI, 0.603\u20130.876) for RS, with a significant paired difference between the two ROC curves (\u0394AUC, 0.162; 95% CI, 0.004\u20130.329;\n p<\/jats:italic>\n \u2009=\u20090.038). The WLI\u2010based model showed better overall predictive performance than the RS\u2010based model, with a lower Brier score (0.0704 vs. 0.0908). On decision curve analysis, the WLI\u2010based model provided greater net benefit throughout the clinically relevant threshold range (0.05\u20130.40).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n WLI may provide an adjunctive, non\u2010stimulating measure for risk stratification in pediatric MRI sedation, although the clinical utility of WLI\u2010guided management should be confirmed in prospective studies.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Clinical Trial Registry of China: ChiCTR2500103661<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pan.70305","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:05:04Z","timestamp":1788775504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["EEG<\/scp>\n \u2010Derived Wavelet Index for Assessment of Procedural Sedation in Children Undergoing Magnetic Resonance Examination: A Diagnostic Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4138-6813","authenticated-orcid":false,"given":"Siyi","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhi","family":"Dan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengqun","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-9557","authenticated-orcid":false,"given":"Jijian","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-8952","authenticated-orcid":false,"given":"Kan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Shanghai Children's Medical Center & National Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1213\/ane.0b013e3181981f96","article-title":"Growth Rates in Pediatric Diagnostic Imaging and Sedation","volume":"108","author":"Wachtel R. 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D.","year":"2023","journal-title":"Biometrical Journal"},{"key":"e_1_2_10_28_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i6","article-title":"Net Benefit Approaches to the Evaluation of Prediction Models, Molecular Markers, and Diagnostic Tests","volume":"352","author":"Vickers A. J.","year":"2016","journal-title":"BMJ"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70305","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:05:07Z","timestamp":1788775507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":27,"alternative-id":["10.1002\/pan.70305"],"URL":"https:\/\/doi.org\/10.1002\/pan.70305","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2026-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pan.70305"}}