OBJECTIVE To find and validate the optimal combination of criteria that define interictal epileptiform EEG discharges (IEDs). Our target was a specificity over 95%, to avoid over-reading in clinical EEG. METHODS We constructed 63 combinations of the six criteria from the operational definition of IEDs, recently issued in the EEG-glossary of the International Federation of Clinical Neurophysiology (IFCN). The diagnostic gold standard was derived from video-EEG recordings. In a testing EEG dataset from 100 patients, we selected the best performing combinations of criteria and then we validated them in an independent dataset from 70 patients. We compared their performance with subjective, expert-scorings and we determined inter-rater agreement (IRA). RESULTS Without using criteria, the specificity of expert-scorings was lower than the pre-defined threshold (86%). The best performing combination of criteria was the following: waves with spiky morphology, followed by a slow-afterwave and voltage map suggesting a source in the brain. In the validation dataset this achieved a specificity of 97% and a sensitivity of 89%. IRA was substantial. CONCLUSIONS The optimized set of criteria for defining IEDs has high accuracy and IRA. SIGNIFICANCE Using these criteria will contribute to decreasing over-reading of EEG and avoid misdiagnosis of epilepsy.

中文翻译：

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用于定义发作间期癫痫样脑电图放电的一组优化标准

目的 寻找并验证定义发作间期癫痫样脑电图放电 (IED) 标准的最佳组合。我们的目标是特异性超过 95%，以避免在临床 EEG 中过度解读。方法 我们根据 IED 的操作定义构建了六个标准的 63 个组合，该定义最近在国际临床神经生理学联合会 (IFCN) 的 EEG 词汇表中发布。诊断金标准来自视频脑电图记录。在来自 100 名患者的测试 EEG 数据集中，我们选择了表现最佳的标准组合，然后在来自 70 名患者的独立数据集中对其进行了验证。我们将他们的表现与主观的专家评分进行了比较，并确定了评分者间的一致性 (IRA)。结果 不使用标准，专家评分的特异性低于预先定义的阈值（86%）。表现最好的标准组合如下：具有尖峰形态的波，其次是缓慢的余波和电压图，表明存在于大脑中。在验证数据集中，这实现了 97% 的特异性和 89% 的灵敏度。IRA 是可观的。结论 用于定义 IED 的优化标准集具有很高的准确性和 IRA。意义 使用这些标准将有助于减少脑电图的过度阅读，避免癫痫的误诊。结论 用于定义 IED 的优化标准集具有很高的准确性和 IRA。意义 使用这些标准将有助于减少脑电图的过度阅读，避免癫痫的误诊。结论 用于定义 IED 的优化标准集具有很高的准确性和 IRA。意义 使用这些标准将有助于减少脑电图的过度阅读，避免癫痫的误诊。