Thatcher's Thoughts
The growth of the field of qEEG depends on flattening the learning curve and making qEEG report writing not only accurate but also easy to do. Most QEEG systems, and especially NeuroGuide™ generate numerous outputs in the form of tables, graphs, brain maps and LORETA outputs. From all these outputs the pertinent ones have to be selected and integrated into a report. A proper and valid report needs to meet certain criteria:
It should summarize how and with what settings the recording was done (technical information), summarize the findings with support from selected tables and maps, how the patient compares against age matched norms with supporting outputs. Broadmann areas that deviate from norm, or may explain the symptoms, should include supporting LORETA outputs, and finally treatment recommendations should be included based on all of the abovementioned information. The report should meet the criteria of good practices of the governing professional organization(s) as well as being acceptable for third parties for reimbursement.
In the past, those that were trained and/or had experience in EEG and QEEG would spend a fair amount of time preparing a report. Those clinicians who did not have the experience or time to write a QEEG report would send the results to outside services to write the report whose turn-around time could include days of delays. These services were often inadequate with unknown and untrained individuals that produced low quality analyses using back yard special databases that had no scientific validity, etc. Also, by sending data to a 3rd party the clinician was not empowered to tailor the data to fit the symptoms of their patients. Also, courts often reject reports produced by outside companies because there is no line of custody of the EEG data and because of the unknown and/or unscientific normative databases and analyses that are used.
As Applied Neuroscience, Inc. grew, clinicians often complained that they did not have the time or expertise to prepare reports. Also, the learning curve was steep and intimidating and it turned off clinicians that did not have the time to learn how to analyze the EEG, save the bitmaps, and write a clinical report. Initially, word processing templates helped but the cutting and pasting of the appropriate outputs still took up too much time. Finally, I consulted the ANI team to see if we could come up with a way to empower the clinician to create a report that was of high quality and could be run on their own computers in a few minutes so that they did not need to send their data to a 3rd party. It was not easy but after a number of products and revisions we were able to come up with an automatic report writer that met professional standards and legal standards which produced a complete report with images and narratives in less than one minute on the clinician's own computer. The end result of all these efforts is the Automatic Clinical Report writer (ACR) that is highlighted in this newsletter. The ACR automatically takes an edited EEG and within 1 minute prepares a multi page well documented QEEG report. The ACR is an invaluable tool to the trained clinician, and will empower the less experienced clinician by preparing the pertinent details of the patient's QEEG findings in a well documented, standardized report. Most important, it significantly flattens the learning curve for clinicians new to QEEG.
May a healthy brain guide all your endeavours.
Best wishes,
Robert Thatcher, PhD
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