Seizure Identification on the Intensive Care Unit (ICU)

Recruiting

• Conditions: Seizures

• Registration Number: NCT07136298
• Lead Sponsor: Nottingham University Hospitals NHS Trust

Brief Summary

The aim of this project is to assess the ability of different groups of National Heath Service (NHS) professionals to correctly identify clinical seizures, and distinguish them from other movements commonly seen in the ICU environment, when shown digital video recordings only.

Patients on the ICU are at risk of having seizures, however also commonly make other movements, including shivering, jerking, tics and tremors. An Electroencephalogram (EEG) records the brain wave activity and can help distinguish epileptic seizures from other movements. In a study by Bendadis et al (2010), 52 video-EEGs were reviewed containing "possible seizures" on the ICU. They found only 27% recorded actual epileptic events, with the other 73% having a range of other movements. Malone et al (2009) studied accuracy of diagnosis of 20 video recordings of clinical episodes on the neonatal unit, comparing different staff groups. They found no significant difference between Doctors and Nurses in correctly identifying seizures, however found that accuracy of diagnosis was generally poor.

Clinical scientists are currently expanding their roles and responsibilities across Neurophysiology, including giving consultant-level advice on EEG investigations. EEG recordings on the ICU are often obscured by excessive, unavoidable electrical/movement artefacts caused by equipment such ventilators and pumps, and patient factors such as position, breathing artefact and suctioning. These make the EEG difficult to interpret (Boggs 2021). Assessing the clinical signs and symptoms which we may see in ICU patients, in the absence of interpretable EEG, is an essential skill.

This study aims to assess Clinical Scientists skills at clinical interpretation, in comparison with other staff groups in the ICU setting. Staff will be asked to watch video clips of events captured in the ICU, and tell us whether they think they are seizures or not, and explain their thought process behind the decision.

Detailed Description

Not available

Study Timeline

• Study Start: 2025-03-03
• Study First Submitted: 2025-07-18
• Status Verified: 2025-08
• Study First Submitted QC: 2025-08-14
• Last Update Submitted: 2025-08-14
• Study First Posted: 2025-08-22
• Last Update Posted: 2025-08-22
• Primary Completion: 2025-08-31
• Study Completion: 2025-08-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

Staff working at Nottingham University Hospitals (NUH) in one of the following staff groups;

• Neurophysiology Scientists/Clinical Physiologists at Band 7 level and above,
• Neurophysiologists who have completed the CCT in Neurophysiology with at least 1 year of Adult ICU experience.
• members of the Neurology medical team with at least 1 years' experience of covering ITU
• Intensivists with at least 1 year's experience working on the Adult intensive care unit
• Nursing staff working on the Intensive care unit with at least 1 year's experience

Exclusion Criteria

• Staff not employed by NUH i.e. agency staff
• Staff in other groups not mentioned above

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Level of Agreement	through study completion, an average of 1 year	The primary outcome measure is the level of agreement between the clinical opinion of the different staff groups and the EEG result

Secondary Outcome Measures

Name	Time	Method
Interrater Reliability	through study completion, an average of 1 year	The level of agreement between the different individuals in each staff group.
Thematic Analysis	through study completion, an average of 1 year	thematic analysis of the decision making process (based on the free text justifications for why individuals made the choice they did)

Trial Locations

Locations (1)

Nottingham University Hospitals; 🇬🇧 Nottingham, Nottinghamshire, United Kingdom