Video quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study. (11th February 2021)

• Record Type: Journal Article
• Authors: Tatum, William O.; Hirsch, Lawrence J.; Gelfand, Michael A.; Acton, Emily K.; LaFrance, W. Curt; Duckrow, Robert B.; Chen, David; Blum, Andrew S.; Hixson, John; Drazkowski, Joe; Benbadis, Selim; Cascino, Gregory D.
• Other Names: Beekman Rachel investigator.; Carvalho Diego investigator.; Marin Collazo Iris Vanessa investigator.; Coonan Erin investigator.; Kleen Jon investigator.; Lopez Alfonso investigator.; Okazaki Erin investigator.; Ranpura Ashish investigator.; Villarino Laura Mainardi investigator.; Yuan Scott investigator.
• Is Part Of: European journal of neurology. Volume 28:Number 5(2021)
• Page Start: 1453
• Page End: 1462
• Publication Date: 2021-02-11
• Subjects: diagnostic test assessment -- epilepsy semiology -- epilepsy/seizures -- nonepileptic seizures -- video/EEG use in epilepsy; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.14744
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: The aim of this study was to evaluate the quality of smartphone videos (SVs) of neurologic events in adult epilepsy outpatients. The use of home video recording in patients with neurological disease states is increasing. Experts interpretation of outpatient smartphone videos of seizures and neurological events has demonstrated similar diagnostic accuracy to inpatient video‐electroencephalography (EEG) monitoring. Methods: A prospective, multicenter cohort study was conducted to evaluate SV quality in patients with paroxysmal neurologic events from August 15, 2015 through August 31, 2018. Epileptic seizures (ESs), psychogenic nonepileptic attacks (PNEAs), and physiologic nonepileptic events (PhysNEEs) were confirmed by video‐EEG monitoring. Experts and senior neurology residents blindly viewed cloud‐based SVs without clinical information. Quality ratings with regard to technical and operator‐driven metrics were provided in responses to a survey. Results: Forty‐four patients (31 women, age 45.1 years [ r = 20–82]) were included and 530 SVs were viewed by a mean of seven experts and six residents; one video per patient was reviewed for a mean of 133.8 s ( r = 9–543). In all, 30 patients had PNEAs, 11 had ESs, and three had PhysNEEs. Quality was suitable in 70.8% of SVs (375/530 total views), with 36/44 (81.8%) patient SVs rated as adequate by the majority of reviewers. Accuracy improved with the presence of convulsive features from 72.4% to 98.2% in ESs and from 71.1% to 95.7% in PNEAs. An accurate diagnosis was given by all reviewers (100%) in 11/44 SVs (all PNEAs). Audio was rated as good by 86.2% of reviewers for these SVs compared with 75.4% for the remaining SVs ( p = 0.01). Lighting was better in SVs associated with high accuracy ( p = 0.06), but clarity was not ( p = 0.59). Poor video quality yielded unknown diagnoses in 24.2% of the SVs reviewed. Features hindering diagnosis were limited interactivity, restricted field of view and short video duration. Conclusions: Smartphone video quality is adequate for clinical interpretation in the majority of patients with paroxysmal neurologic events. Quality can be optimized by encouraging interactivity with the patient, adequate duration of the SV, and enlarged field of view during videography. Quality limitations were primarily operational though accuracy remained for SV review of ESs and PNEAs. Abstract : Smartphone video quality is adequate for clinical interpretation in the majority of patients with paroxysmal neurological events. Encouraging patient interactivity, 2 min duration, and use of enlarged fields of view during smartphone videography will minimize technological hindrances and maximize quality for ES and PNEA SV recording.