A Hybrid Artificial Intelligence System for Automated EEG Background Analysis and Report Generation

Electroencephalography (EEG) plays a crucial role in the diagnosis of various neurological disorders. However, small hospitals and clinics often lack advanced EEG signal analysis systems and are prone to misinterpretation in manual EEG reading. This study proposes an innovative hybrid artificial intelligence (AI) system for automatic interpretation of EEG background activity and report generation. The system combines deep learning models for posterior dominant rhythm (PDR) prediction, unsupervised artifact removal, and expert-designed algorithms for abnormality detection. For PDR prediction, 1530 labeled EEGs were used, and the best ensemble model achieved a mean absolute error (MAE) of 0.237, a root mean square error (RMSE) of 0.359, an accuracy of 91.8% within a 0.6 Hz error, and an accuracy of 99% within a 1.2 Hz error. The AI system significantly outperformed neurologists in detecting generalized background slowing (p = 0.02; F1: AI 0.93, neurologists 0.82) and demonstrated improved focal abnormality detection, although not statistically significant (p = 0.79; F1: AI 0.71, neurologists 0.55). Validation on both an internal dataset and the Temple University Abnormal EEG Corpus showed consistent performance (F1: 0.884 and 0.835, respectively; p = 0.66), demonstrating generalizability. The use of large language models (LLMs) for report generation demonstrated 100% accuracy, verified by three other independent LLMs. This hybrid AI system provides an easily scalable and accurate solution for EEG interpretation in resource-limited settings, assisting neurologists in improving diagnostic accuracy and reducing misdiagnosis rates.