Noise in the diagnosis of epilepsy by experts

The degree of noise in expert diagnosis of epilepsy is substantial, stemming primarily from physicians' idiosyncratic interpretations of case features and variable dispositions toward over- or under-diagnosis. Strategies to improve reliability are needed, including standardized data collection protocols and structured decision algorithms. For "difficult cases," where expert reliability and accuracy are lowest, our findings support current clinical practice which favors early referral for video-EEG monitoring over reliance on diagnostic anchoring. This diagnostic pathway may become more accessible with advances in EEG technology (e.g., wearable devices) and artificial intelligence.

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Publication Details

Journal
Epileptic Disorders
Published
2026-01-20
DOI
https://doi.org/10.1002/epd2.70181
Primary Topic
Epilepsy research and treatment
Type
article
Field-Weighted Citation Impact
0.00
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article

Noise in the diagnosis of epilepsy by experts

Olivier Sibony, Stephan Schuele, Jay R. Gavvala, J. H. Williams et al.
Epileptic Disorders
Epilepsy research and treatment
article

Noise in the diagnosis of epilepsy by experts

Olivier Sibony, Stephan Schuele, Jay R. Gavvala, J. H. Williams, Roohi Katyal, Nirav Barot, Danah Aljaafari, Atul Maheshwari, William O. Tatum, Rampp Stefan, Joseph I Sirven, Fábio A. Nascimento, Sándor Beniczky, R. Edward Hogan, John R. McLaren, Wan Yee Kong, M. Brandon Westover, Doyle Yuan, Ioannis Karakis, Wei Zhao, Irfan S. Sheikh, Rebecca Matthews, Selim Benbadis, Daniel Friedman, Jonathan Halford
article en

Abstract

The degree of noise in expert diagnosis of epilepsy is substantial, stemming primarily from physicians' idiosyncratic interpretations of case features and variable dispositions toward over- or under-diagnosis. Strategies to improve reliability are needed, including standardized data collection protocols and structured decision algorithms. For "difficult cases," where expert reliability and accuracy are lowest, our findings support current clinical practice which favors early referral for video-EEG monitoring over reliance on diagnostic anchoring. This diagnostic pathway may become more accessible with advances in EEG technology (e.g., wearable devices) and artificial intelligence.

Epileptic Disorders
Northwestern University (US), Boston Children's Hospital (US), Beth Israel Deaconess Medical Center (US), Johns Hopkins University (US), Emory University (US), Medical University of South Carolina (US), Baylor College of Medicine (US), Washington University in St. Louis (US), Louisiana State University in Shreveport (US), Johns Hopkins Medicine (US), King Fahd Hospital of the University (SA), Jacksonville College (US), Tampa General Hospital (US), Aarhus University Hospital (DK), Universitätsklinikum Erlangen (DE), Danish Pain Research Center (DK), Mayo Clinic in Florida (US), Johns Hopkins Hospital (US), University Hospital in Halle (DE), The University of Texas Health Science Center (US), Wake Forest University (US), New York University (US), Louisiana State University Health Sciences Center Shreveport (US), HEC Paris (FR), The University of Texas Southwestern Medical Center (US), Universidade Federal de São Paulo (BR)
Openalex Percentile: Top 83%
Epilepsy research and treatment
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