Key points:
- A prediction model can better help doctors determine which newborns need continuous seizure monitoring, and which do not.
- In tests, the model demonstrated more than 90% accuracy.
- This is the first seizure prediction model based on clinically derived standardized report.
Approximately 30% of newborn babies with temporary lack of oxygen to the brain (known as hypoxic-ischemic encephalopathy, or HIE) will have seizures. Most of these seizures can only be detected through EEG monitoring. Current guidelines suggest that newborns with HIE undergo four to five days of EEG monitoring. However, this approach is not always feasible, as many of these babies receive care in NICUs that do not have access to continuous EEG. Additionally, EEG monitoring can be invasive.
Now, researchers at CHOP have developed a prediction model that determines which newborn babies are likely to experience seizures in the NICU. The model could be incorporated into routine care to help the clinical team decide which babies will need EEGs and which can be safely managed without monitoring.
In their study, published in The Lancet Digital Health, the researchers used data from the EEGs of more than 1,000 newborns to build seizure prediction models. The retrospective study found that these models could predict seizures, particularly seizures in newborns with HIE, with more than 90% accuracy. The models could be tuned to not miss seizures, performing with sensitivity of up to 97% in the overall cohort and 100% among newborns with HIE while maintaining high precision.
The authors say this is the first study reporting on a seizure prediction model based on clinically derived standardized reports. The study team has made the model publicly available as an online tool.
“If we can further validate this model, it could enable a more targeted use of limited EEG resources by reducing EEG use in low-risk patients, which will make care of babies with neurological concerns in the NICU more personalized and focused,” said senior study author Ingo Helbig, MD, a pediatric neurologist in the Division of Neurology and co-director of ENGIN (Epilepsy NeuroGenetics Institute) at CHOP. “We believe incorporating this model into real-time clinical practice could greatly improve the quality and efficiency of the care we deliver in these critical early days of life.”
Information from CHOP.