Abstracts

Rationale: Ongoing and focused professional practice evaluations have been a Joint Commission requirement since January 1, 2008. EEG is one of the most common procedures in neurology. Its interpretation is subjective and therefore a possibility for inter-rater variability exists. As one of the quality control measures we sought to determine if there are significant discrepancies in our faculty s EEG interpretations, and created a measurement tool modified from the method published by the American College of Radiology.Methods: EEG Peer Review Methodology Ten (10) randomly chosen EEG studies per year for each practitioner are reviewed independently by a peer reviewer from the following EEG categories: 1). Routine EEGs 8 studies per year to be reviewed per practitioner. 2). Continuous EEGs (cEEGs) from the ICU from University Hospital (one 24 hour recording equals one study) 2 studies per year to be reviewed per practitioner. Video/EEG studies for patients admitted for epilepsy monitoring are reviewed at epilepsy surgery conference. Two studies of epileptic seizures per year and one nonepileptic seizure study per year are reviewed per practitioner. Each EEG is assigned a score by the peer reviewer (Table 1). Our benchmark is to attain 100% agreement (score of 1 or 2a). Studies with scores of 2b and 3 are sent for a second peer review. If the two reviewers do not agree, then a score is determined by arbitration.Results: For three quarters, 29 routine EEGs have been peer reviewed (average of 5.8 EEGs per practitioner). 28 of 29 routine EEGs were scored 1 (Concur with interpretation) while one EEG was scored 2a (Discrepancy in interpretation/not ordinarily expected to be made [understandable miss], unlikely to be clinically significant). Three cEEGs have been reviewed, all were scored a 1. Nine EMU studies have been reviewed, all with scores of 1. Conclusions: Peer review of EEGs done at our institution showed remarkable consistency in interpretation among our faculty physicians. EEG peer review is an important quality measure for epilepsy/clinical neurophysiology programs that may be of value to hospital administration for overall quality metrics.