{"doi":"10.1111/epi.18365","title":"Validation of a discrete electrographic seizure detection algorithm for extended‐duration, reduced‐channel wearable EEG","abstract":"OBJECTIVE: Reduced-channel wearable electroencephalography (EEG) may overcome the accessibility and patient comfort limitations of traditional ambulatory electrographic seizure monitoring during extended-duration use. Automated algorithms are necessary for review of extended-duration reduced-channel EEG, yet current clinical support software is designed only for full-montage recordings. METHODS: The performance of a novel automated seizure detection algorithm for reduced-channel EEG (Epitel) was evaluated in a clinical validation study involving 50 participants (31 with seizures) with diverse demographic and seizure representation. RESULTS: The algorithm demonstrated an event-level sensitivity of 86.2% (95% confidence interval [CI] = 79.5%-93.2%) and a false detection rate of .162 per hour (95% CI = .116-.221), which is comparable to the performance of current clinical software for full-montage EEG. Performance varied by electrographic seizure type, with 91.4% sensitivity for focal evolving to generalized seizures, 86.7% for generalized seizures, and 77.3% for focal seizures. The algorithm maintained robust performance in both pediatric participants aged 6-21 years (83% sensitivity) and adults aged 22+ years (90% sensitivity), as well as in ambulatory (80%) and epilepsy monitoring unit (EMU) monitoring environments (87.5%). The false detection rate in ambulatory monitoring environments (.290 false positive [FP] detections/h), all of which involved pediatric participants, was notably higher than in the EMU (.136 FP/h), indicating an area with clear need for improvement for unrestricted at-home monitoring. The algorithm's supplemental Confidence metric, designed to engender trust in the algorithm, showed a strong correlation with detection precision. SIGNIFICANCE: These results suggest that this algorithm can provide crucial support for review of extended-duration reduced-channel wearable EEG, enabling electrographic seizure monitoring with no restrictions on a person's daily life.","journal":"Epilepsia","year":2025,"id":540690,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9599,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":693303,"name":"Mitchell A. Frankel","orcid":null,"position":1,"is_corresponding":false},{"id":1416565,"name":"Zoë Tosi","orcid":null,"position":2,"is_corresponding":false},{"id":1416113,"name":"Avidor B. Kazen","orcid":"0009-0007-4676-1912","position":3,"is_corresponding":false},{"id":1416564,"name":"Vamshi K. Muvvala","orcid":null,"position":4,"is_corresponding":false},{"id":337308,"name":"Tobias Loddenkemper","orcid":"0000-0003-2074-0674","position":5,"is_corresponding":false},{"id":693306,"name":"Mark C. Spitz","orcid":null,"position":6,"is_corresponding":false},{"id":734953,"name":"Laura Strom","orcid":"0000-0002-3297-5908","position":7,"is_corresponding":false},{"id":388874,"name":"Daniel Friedman","orcid":"0000-0003-1068-1797","position":8,"is_corresponding":false},{"id":692707,"name":"Mark J. Lehmkuhle","orcid":"0000-0002-1206-2554","position":9,"is_corresponding":false},{"id":1416114,"name":"Tyler Newton","orcid":"0000-0002-1560-6553","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T02:52:42.901627Z","pmid":"40108974","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}