Status: Funded - Closed
A smartphone-electroencephalogram to diagnose pediatric epilepsy in Bhutan
Farrah Mateen, M.D., Ph.D.
BACKGROUND: Epilepsy – the tendency to recurrent, unprovoked seizures – is an important cause of treatable disability in children and young adults and may have multiple negative medical, social, and economic consequences. Approximately one percent of children have seizures worldwide; that percentage is almost certainly higher, but unquantified, in low-income countries.
GAP: There is a critical need for a portable, real-time, diagnostic electroencephalogram (EEG) device that can be incorporated into routine initial diagnosis and care of children with suspected seizure disorders.
HYPOTHESIS: A recently designed EEG-smartphone will have comparable accuracy to standard, stationary EEG equipment in terms of both positive and negative predictive value (+/-5%) and accurately diagnose children with seizures in the Himalayan Kingdom of Bhutan.
METHODS: A prospective cohort study of children <21 years old was performed at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan from summer 2014 to spring 2015. Participants were evaluated through consecutive testing of a Smartphone Brain Scanner mobile phone and tablet-based EEG recording device and stationary EEG (XLTEK, Natus) for approximately 25 minutes each. Participants also had a structured clinical interview and questionnaire, as well as parental proxy reporting on quality of life, microeconomics, and stigma.
RESULTS: There were 107 participants under age 21 recruited (51% female, mean age 11.9). There were no safety concerns and the smartphone EEG device was tolerated well by participants. Operation of the Smartphone Brain Scanner app was performed facilely by both medical and non-medical health care workers in Bhutan. Recordings were captured in 83 participants including SBS smartphone EEGs and XLTEK EEGs. Preliminary results show concordance of 34 among 54 of EEGs read to date (63%). Further analyses are currently pending.
IMPACT: If successful, clinical validation of this technological innovation has the potential for widespread scale-up in multiple resource-limited settings but also has the potential for reverse innovation, positively affecting the diagnosis of seizures in children living in countries beyond Bhutan.
Massachusetts General Hospital
United States, Bhutan