Seizure Identification on the Intensive Care Unit (ICU)

NCT07136298 | Recruiting

• 1 other identifier: 24CN001
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

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.

Conditions

Seizures

Keywords

Intensive Care; Clinical Scientist; Neurologists; Intensivists; ITU Nurses

Outcome Measures

Primary Outcomes (1)

• Level of Agreement

  The primary outcome measure is the level of agreement between the clinical opinion of the different staff groups and the EEG result

  through study completion, an average of 1 year

Secondary Outcomes (2)

• Interrater Reliability

  through study completion, an average of 1 year

• Thematic Analysis

  through study completion, an average of 1 year

Study Arms (6)

Clinical Scientists

Other: Clinical Opinion

Advanced Clinical Practitioners

Other: Clinical Opinion

Intensivists

Other: Clinical Opinion

Clinical Neurophysiologists

Other: Clinical Opinion

Neurologists

Other: Clinical Opinion

ICU Nurses

Other: Clinical Opinion

Interventions

Clinical Opinion OTHER

Staff participants will be asked to review video clips of events captured during EEGs performed on the ICU and asked to state whether they think the event was an epileptic seizure or not, and what aspects of each event led them to that decision

Advanced Clinical Practitioners; Clinical Neurophysiologists; Clinical Scientists; ICU Nurses; Intensivists; Neurologists

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population are staff working in the Adult ICU at Nottingham University Hospitals, in one of the following groups; Neurophysiology Scientists/Clinical Physiologists, Neurophysiologists, Neurologists, Intensivists, Advanced Clinical Practitioners and Nursing Staff

You may qualify if:

• 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

You may not qualify if:

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

Sponsors & Collaborators

• Nottingham University Hospitals NHS Trust: lead

Study Sites (1)

Nottingham University Hospitals

Nottingham, Nottinghamshire, NG7 2UH, United Kingdom

RECRUITING

MeSH Terms

Conditions

Seizures

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

James S Baird

CONTACT

01159709146; james.baird@nhs.net

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 18, 2025
• First Posted: August 22, 2025
• Study Start: March 3, 2025
• Primary Completion: August 31, 2025
• Study Completion: August 31, 2025
• Last Updated: August 22, 2025

Record last verified: 2025-08

Locations

GB (1)