Modeling the economic value of Ceribell Rapid Response EEG in the inpatient hospital setting

Ney, John P.; Gururangan, Kapil; Parvizi, Josef

doi:10.1080/13696998.2021.1887877

Cited by 14 publications

(11 citation statements)

References 34 publications

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“…We found relatively high rates of antiseizure medication treatment preceding pocEEG monitoring, however we did not observe any significant differences in pre‐pocEEG anti‐seizure medication treatment rates associated with subsequent pocEEG detection of epileptiform versus non‐epileptiform activity, suggesting that clinical suspicion alone can be unreliable in diagnosing such abnormalities. This same phenomenon was previously demonstrated in the Does Use of Rapid Response EEG Impact Clinical Decision Making (DECIDE) multicenter study of Ceribell pocEEG, and a subsequent economic analysis projected the financial impacts of inappropriate or inaccurate treatment in terms of excess rates of intubation and prolonged ICU and hospital length of stay ranged from $3971 to $17,290 per patient 4,14 …”

Section: Discussionsupporting

confidence: 62%

Point‐of‐care electroencephalography enables rapid evaluation and management of non‐convulsive seizures and status epilepticus in the emergency department

et al. 2023

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ObjectivesTo describe our institutional experience with point‐of‐care electroencephalography (pocEEG) and its impact on the evaluation/management of suspected non‐convulsive seizures in the emergency department (ED).MethodsWe retrospectively identified 157 adults who underwent pocEEG monitoring in our community hospital ED in 1 year. We calculated the time to obtain pocEEG in the ED (door‐to‐EEG time) and examined the impact of pocEEG findings (categorized as seizure, highly epileptiform patterns, slowing, or normal activity) on antiseizure medication treatment.ResultsPocEEG revealed seizures (14%, n = 22), highly epileptiform patterns (22%, n = 34), slowing (44%, n = 69), and normal activity (20%, n = 32). The median door‐to‐EEG time (from initial ED evaluation to pocEEG monitoring) was only 1.2 hours (interquartile range 0.1–2.1) even though 55% of studies were performed after‐hours (5 pm–9 am). Most patients were admitted (54% to the intensive care unit, 41% to floor). Antiseizure medication treatment occurred pre‐pocEEG in 93 patients (59%) and post‐pocEEG in 88 patients (56%). By reviewing the relationship between pocEEG monitoring and antiseizure medication management, we found a significant association between pocEEG findings and changes in management (P < 0.001). Treatment escalation occurred more frequently in patients with epileptiform activity (seizures or highly epileptiform patterns, 52%) than patients with non‐epileptiform activity (normal or slow, 25%, P < 0.001), and avoidance of treatment escalation occurred more frequently in patients with normal or slow activity (27%) than patients with seizures or highly epileptiform patterns (2%, P < 0.001).ConclusionOur study, the largest to date describing the real‐world use of pocEEG in emergency medicine, found that rapid EEG acquisition in the ED was feasible in a community hospital and significantly affected the management of suspected non‐convulsive seizures.

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Section: Discussionsupporting

confidence: 62%

Point‐of‐care electroencephalography enables rapid evaluation and management of non‐convulsive seizures and status epilepticus in the emergency department

et al. 2023

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“…Noninvasive mobile EEG solutions could also have an impact on the economy of health services 71 . The possibility to automatically detect seizures could decrease the time spent by clinicians reviewing EEG for conventional assessment and can be useful in patients with a low frequency of events 72,73 .…”

Section: Discussionmentioning

confidence: 99%

“…Noninvasive mobile EEG solutions could also have an impact on the economy of health services. 71 The possibility to automatically detect seizures could decrease the time spent by clinicians reviewing EEG for conventional assessment and can be useful in patients with a low frequency of events. 72,73 The cost of the systems may be lower compared to conventional in-hospital scalp EEG and may not be limited by the availability of hospital resources.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive mobile EEG as a tool for seizure monitoring and management: A systematic review

et al. 2022

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In the last two decades new noninvasive mobile electroencephalography (EEG) solutions have been developed to overcome limitations of conventional clinical EEG and to improve monitoring of patients with long‐term conditions. Despite the availability of mobile innovations, their adoption is still very limited. The aim of this study is to review the current state‐of‐the‐art and highlight the main advantages of adopting noninvasive mobile EEG solutions in clinical trials and research studies of people with epilepsy or suspected seizures. Device characteristics are described, and their evaluation is presented. Two authors independently performed a literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A combination of different digital libraries was used (Embase, MEDLINE, Global Health, PsycINFO and https://clinicaltrials.gov/). Twenty‐three full‐text, six conference abstracts, and eight webpages were included, where a total of 14 noninvasive mobile solutions were identified. Published studies demonstrated at different levels how EEG recorded via mobile EEG can be used for visual detection of EEG abnormalities and for the application of automatic‐detection algorithms with acceptable specificity and sensitivity. When the quality of the signal was compared with scalp EEG, many similarities were found in the background activities and power spectrum. Several studies indicated that the experience of patients and health care providers using mobile EEG was positive in different settings. Ongoing trials are focused mostly on improving seizure‐detection accuracy and also on testing and assessing feasibility and acceptability of noninvasive devices in the hospital and at home. This review supports the potential clinical value of noninvasive mobile EEG systems and their advantages in terms of time, technical support, cost, usability, and reliability when applied to seizure detection and management. On the other hand, the limitations of the studies confirmed that future research is needed to provide more evidence regarding feasibility and acceptability in different settings, as well as the data quality and detection accuracy of new noninvasive mobile EEG solutions.

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“…However, recent studies suggest the implementation of RRLM-EEG may reduce overall healthcare costs. Ney et al evaluated RRLM-EEG cost-benefits in the hospital and found that each use of RRLM-EEG as a Rapid-EEG system saved between $3971 and $17,290 [ 25 •]. These cost-benefits result from reduced hospitalizations and unnecessary use of antiseizure medications in those with suspected NCSE [ 26 – 28 ].…”

Section: Cost and Accessibilitymentioning

confidence: 99%

Rapid Response EEG: Current State and Future Directions

Davey

Gupta

et al. 2022

Curr Neurol Neurosci Rep

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Purpose of Review To critically appraise the literature on the application, methods, and advances in emergency electroencephalography (EEG). Recent Findings The development of rapid EEG (rEEG) technologies and other reduced montage approaches, along with advances in machine learning over the past decade, has increased the rate and access to EEG acquisition. These achievements have made EEG in the emergency setting a practical diagnostic technique for detecting seizures, suspected nonconvulsive status epilepticus (NCSE), altered mental status, stroke, and in the setting of sedation. Summary Growing evidence supports using EEG to expedite medical decision-making in the setting of suspected acute neurological injury. This review covers approaches to acquiring EEG in the emergency setting in the adult and pediatric populations. We also cover the clinical impact of this data, the time associated with emergency EEG, and the costs of acquiring EEG in these settings. Finally, we discuss the advances in artificial intelligence for rapid electrophysiological interpretation.

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Modeling the economic value of Ceribell Rapid Response EEG in the inpatient hospital setting

Cited by 14 publications

References 34 publications

Point‐of‐care electroencephalography enables rapid evaluation and management of non‐convulsive seizures and status epilepticus in the emergency department

Point‐of‐care electroencephalography enables rapid evaluation and management of non‐convulsive seizures and status epilepticus in the emergency department

Noninvasive mobile EEG as a tool for seizure monitoring and management: A systematic review

Rapid Response EEG: Current State and Future Directions

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