(201 days)
Not Found
Yes
The device name itself includes "AI" (REMI-AI Discrete Detection Module), and the description explicitly mentions training and validating an "algorithm" using EEG data to identify potential electrographic seizure events.
No.
The device is described as an "aide" to physicians for reviewing EEG recordings by marking potential neurological events. It explicitly states that it "does not provide any diagnostic conclusion about the patient's condition to the user" and "does not mark REMI EEG records in real time." This indicates it is a diagnostic aid, not a device that directly treats or prevents a condition.
No
The device is explicitly stated as not providing any diagnostic conclusion: "REMI-AI DDM does not mark REMI EEG records in real time and does not provide any diagnostic conclusion about the patient's condition to the user." Instead, it functions as an "aide to the qualified physician's REMI EEG review" by marking sections that "may correspond to neurological events of interest."
Yes
The device description explicitly states that REMI-AI DDM is "software as a medical device (SaMD)". While it analyzes data from the REMI Remote EEG Monitoring System, the device itself is the software component that performs the analysis.
Based on the provided information, this device is not an In Vitro Diagnostic (IVD).
Here's why:
- IVDs analyze biological samples (like blood, urine, tissue) to provide information about a patient's health. The REMI-AI DDM analyzes electroencephalogram (EEG) recordings, which are electrical signals from the brain, not biological samples in the traditional sense of an IVD.
- The intended use is to aid in the review of EEG recordings by qualified physicians. It does not directly analyze a biological sample to diagnose a condition.
- The device description explicitly states it analyzes previously acquired EEG data. This reinforces that it's working with electrical signals, not biological material.
Therefore, the REMI-AI DDM falls under the category of a medical device, specifically Software as a Medical Device (SaMD), but not an In Vitro Diagnostic.
Yes
The letter explicitly states, "The REMI-AI DDM has been cleared by the US FDA with an Authorized PCCP."
Intended Use / Indications for Use
The REMI-AI Discrete Detection Module (REMI-AI DDM) is indicated for the analysis of REMI Remote EEG Monitoring System electroencephalogram (EEG) recordings. REMI-AI DDM is intended to be used by physicians qualified to analyze and interpret EEG who will exercise professional judgment in using the information.
As an aide to the qualified physician's REMI EEG review. REMI-AI DDM marks previously acquired sections of REMI EEG that may correspond to neurological events of interest indicative of potential electrographic seizures lasting at least 10 seconds in duration. REMI-AI DDM is indicated for use with adult and pediatric patients (6+ years).
REMI-AI DDM does not mark REM EEG records in real time and diagnostic conclusion about the patient's condition to the user.
Product codes (comma separated list FDA assigned to the subject device)
OMB
Device Description
REMI-Al Discrete Detection Module (REMI-AI DDM) is a software as a medical device (SaMD) that automatically identifies and annotates discrete seizure-like events in previously acquired electroencephalography (EEG) traces to aid a qualified physician in their review of REMI EEG records. REMI-AI DDM analyzes previously acquired EEG data from 4-channel recordings obtained from bilateral, bipolar scalp EEG recordings at both the frontal and temporoparietal regions, collected and stored by the REMI Remote EEG Monitoring System. REMI-AI DDM analyzes EEG recordings and detects regions of the data that may correspond to electrographic seizures lasting at least 10 seconds in duration. These regions are annotated in the REMI EEG file as discrete events and are provided to assist in REMI EEG review.
Mentions image processing
Not Found
Mentions AI, DNN, or ML
REMI-AI Discrete Detection Module (REMI-AI DDM)
Input Imaging Modality
Electroencephalogram (EEG)
Anatomical Site
Scalp (frontal and temporoparietal regions)
Indicated Patient Age Range
Adult and pediatric patients (6+ years)
Intended User / Care Setting
Physicians qualified to analyze and interpret EEG. No specific care setting mentioned, but validation data collected in Epilepsy Monitoring Units (EMUs) or during at-home ambulatory EEG monitoring.
Description of the training set, sample size, data source, and annotation protocol
EEG data from adult and pediatric patients was used to train the REMI-AI DDM algorithm. Patients wore REMI wireless EEG sensors at bilateral frontal and temporoparietal scalp sites alongside standard-of-care 19-channel, full-montaqe, video-EEG for up to 7 continuous days in Epilepsy Monitoring Units (EMUs) or for up to 3 continuous days during at-home ambulatory EEG monitoring. The training set consisted of 108 patient records (73 seizure patients, 35 non-seizure patients). Demographics include:
- Age: 43 (40%) Child (≤21), 65 (60%) Adult (22+)
- Gender: 46 (43%) Male, 62 (57%) Female
- Environment: 85 (79%) EMU, 23 (21%) Ambulatory
A summary of electrographic seizure types and their counts in the training set: - Focal: 254 (45%)
- Focal Evolving to Generalized: 39 (7%)
- Generalized: 269 (48%)
The duration of seizure record data for the training set is detailed by seizure type in Table 10.5.
Description of the test set, sample size, data source, and annotation protocol
EEG data used to generate a reference standard for REMI-AI DDM was collected from standard 19+channel wired 10-20 montage EEG records acquired concurrently with REMI 4-channel EEG. Prior to inclusion in the validation data set, all subjects' EEG records underwent panel review by 3 independent expert epileptologists. Experts consisted of a panel of 6 epileptologists, holding certification by the American Board of Psychiatry and Neurology or certification by the American Board of Clinical Neurophysiology with Special Competency in Epilepsy Monitoring. Consensus ground truth electrographic seizure negative determinations were made using the wired EEG records when at least 2 of 3 members identified the presence or absence of an electrographic seizure event.
The REMI-AI DDM validation data set consisted of 31 patient records with 87 consensus-determined electrographic seizures lasting at least 10 seconds in duration, and 19 patient records with no consensus-determined electrographic seizures, for a total validation sample size of 50. All attempts were made to ensure diverse subject demographics. Demographics include:
- Age: 24 (48%) Child (≤21), 26 (52%) Adult (22+)
- Gender: 26 (52%) Male, 24 (48%) Female
- Environment: 38 (76%) EMU, 12 (24%) Ambulatory
The consensus-determined electrographic seizures represented in the validation data set include: Focal, Focal Evolving to Generalized, Generalized.
A summary of electrographic seizure types and their counts in the test set: - Focal: 22 (25%)
- Focal Evolving to Generalized: 35 (40%)
- Generalized: 30 (34%)
The duration of seizure record data for the test set is detailed by seizure type in Table 10.5.
Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)
Study Type: Clinical Validation (algorithm performance), Software Verification, Human Factors Validation.
Sample Size:
- Clinical Validation: 50 patient records (31 with seizures, 19 without seizures) for the validation dataset. Total 2562.5 hours of EEG data.
- Human Factors Validation: Representative epileptologist reviewers.
Key Results: - REMI-AI DDM validation was evaluated against a combined primary endpoint of Sensitivity > 70% and of a False Alarm Rate (FAR) 70% (with a calculated 95% Cl lower bound of 79.5%) and FAR
§ 882.1400 Electroencephalograph.
(a)
Identification. An electroencephalograph is a device used to measure and record the electrical activity of the patient's brain obtained by placing two or more electrodes on the head.(b)
Classification. Class II (performance standards).
0
January 3, 2024
Image /page/0/Picture/1 description: The image shows the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.
Epitel, Inc. Randy Parry Staff Regulatory Affairs Specialist 465 S 400 E Suite 250 Salt Lake City, Utah 84111
Re: K231779
Trade/Device Name: REMI AI Discrete Detection Module Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: Class II Product Code: OMB Dated: December 1, 2023 Received: December 1, 2023
Dear Randy Parry:
We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
FDA's substantial equivalence determination also included the review and clearance of your Predetermined Change Control Plan (PCCP). Under section 515C(b)(1) of the Act, a new premarket notification is not required for a change to a device cleared under section 510(k) of the Act, if such change is consistent with an
1
established PCCP granted pursuant to section 515C(b)(2) of the Act. Under 21 CFR 807.81(a)(3), a new premarket notification is required if there is a major change or modification in the intended use of a device, or if there is a change or modification in a device that could significantly affect the safety or effectiveness of the device, e.g., a significant change or modification in design, material, chemical composition, energy source, or manufacturing process. Accordingly, if deviations from the established PCCP result in a major change or modification in the intended use of the device, or result in a change or modification in the device that could significantly affect the safety or effectiveness of the a new premarket notification would be required consistent with section 515C(b)(1) of the Act and 21 CFR 807.81(a)(3). Failure to submit such a premarket submission would constitute adulteration and misbranding under sections 501(f)(1)(B) and 502(o) of the Act, respectively.
Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).
Your device is also subject to, among other requirements, the Quality System (OS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatory
2
assistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Jay R. Gupta -S
Jay Gupta Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
3
Indications for Use
510(k) Number (if known) K231779
Device Name
REMI-AI Discrete Detection Module (REMI-AI DDM)
Indications for Use (Describe)
The REMI-AI Discrete Detection Module (REMI-AI DDM) is indicated for the analysis of REMI Remote EEG Monitoring System electroencephalogram (EEG) recordings. REMI-AI DDM is intended to be used by physicians qualified to analyze and interpret EEG who will exercise professional judgment in using the information.
As an aide to the qualified physician's REMI EEG review. REMI-AI DDM marks previously acquired sections of REMI EEG that may correspond to neurological events of interest indicative of potential electrographic seizures lasting at least 10 seconds in duration. REMI-AI DDM is indicated for use with adult and pediatric patients (6+ years).
REMI-AI DDM does not mark REM EEG records in real time and diagnostic conclusion about the patient's condition to the user.
Type of Use (Select one or both, as applicable) | |
---|---|
☒ Prescription Use (Part 21 CFR 801 Subpart D) | ☐ Over-The-Counter Use (21 CFR 801 Subpart C) |
CONTINUE ON A SEPARATE PAGE IF NEEDED.
This section applies only to requirements of the Paperwork Reduction Act of 1995.
DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.
The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:
Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov
"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."
4
Image /page/4/Picture/1 description: The image shows the logo for "epitel". The logo is in a dark blue color. The "i" in "epitel" is stylized with a waveform graphic.
REMI-Al Discrete Detection Module (REMI-AI DDM) 510(k) SUMMARY
1. Applicant Information
Epitel, Inc. 465 S 400 E, Suite 250 Salt Lake City, UT 84111
Primary Contact Information
Randy Parry Staff Regulatory Affairs Specialist
Secondary Contact Information
Christopher M. Phillips VP, Regulatory Affairs and Quality
Date Prepared
December 27, 2023
2. Subject Device Information
Name of Device: REMI-Al Discrete Detection Module (REMI-AI DDM) Common or Usual Name: EEG System Classification Name: Automatic Event Detection Software For Full-Montage Electroencephalograph Regulatory Class: Class II Product Code and Regulation Number: OMB - Sec. 882.1400
3. Predicate Device
Name of Device: Persyst 14 EEG Review and Analysis Software 510(k) Number: K182181 Manufacturer: Persyst Development Corporation
4. Device Description
REMI-Al Discrete Detection Module (REMI-AI DDM) is a software as a medical device (SaMD) that automatically identifies and annotates discrete seizure-like events in previously acquired electroencephalography (EEG) traces to aid a qualified physician in their review of REMI EEG records. REMI-AI DDM analyzes previously acquired EEG data from 4-channel recordings obtained from bilateral, bipolar scalp EEG recordings at both the frontal and temporoparietal regions, collected and stored by the REMI Remote EEG Monitoring System. REMI-AI DDM analyzes EEG recordings and detects regions of the data that may correspond to electrographic seizures lasting at least 10 seconds in duration. These regions are annotated in the REMI EEG file as discrete events and are provided to assist in REMI EEG review.
5
5. Indications for Use
The REMI-AI Discrete Detection Module (REMI-AI DDM) is indicated for the analysis of REMI Remote EEG Monitoring System electroencephalogram (EEG) recordings. REMI-AI DDM is intended to be used by physicians qualified to analyze and interpret EEG who will exercise professional judgment in using the information.
As an aide to the qualified physician's REMI EEG review, REMI-AI DDM marks previously acquired sections of REMI EEG that may correspond to neurological events of interest indicative of potential electrographic seizures lasting at least 10 seconds in duration. REMI-AI DDM is indicated for use with adult and pediatric patients (6+ years).
REMI-AI DDM does not mark REMI EEG records in real time and does not provide any diagnostic conclusion about the patient's condition to the user.
6. Predicate Selection
In alignment with FDA Draft Guidance Best Practices for Selecting a Predicate Device to Support a Premarket Notification [510(k)] Submission - Draft Guidance for Industry and Food and Drug Administration Staff, a predicate device has been selected. Potential predicates were reviewed and the Persyst 14 EEG Review and Analysis Software predicate device was selected as it meets or exceeds the expected safety and performance, does not have unmitigated userrelated or design related safety issues and is not associated with any design-related recalls.
7. Substantial Equivalence
REMI-AI DDM has been developed in compliance with applicable FDA requirements and guidance as well as with recognized standards. This submission includes required documentation and testing data demonstrating substantial equivalence of REMI-AI DDM to its predicate device, Persyst 14. REMI-AI DDM has undergone software testing, human factors/usability testing, and Clinical Validation which demonstrate that it is safe and effective for its intended use. Assessment of the technological characteristics, intended use, and conclusions drawn from the verification tests, presented in their respective sections of this submission, demonstrate that the device is as safe and effective as the legally marketed predicate device.
6
Image /page/6/Picture/1 description: The image shows the logo for "epitel". The logo is in blue and features a stylized "p" with a waveform graphic inside. The rest of the letters are in a simple sans-serif font.
7.1 Summary of Technological Characteristics and Substantial Equivalence to Predicate Device
| Attribute | Subject Device
REMI Discrete Detection Module (REMI-AI DDM)
(K231779) | Predicate Device
Persyst 14 EEG Review and Analysis Software
(K182181) |
|-------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Classification and
Regulation | Class II per 21 CFR 882.1400
Automatic Event Detection Software for Full-
Montage Electroencephalograph | Class II per 21 CFR 882.1400
Automatic Event Detection Software for Full-
Montage Electroencephalograph |
| FDA Product Code(s) | OMB | OMB |
| Intended Use | Automatically identify and annotate events of
interest in electroencephalograph traces to aid with
EEG review. | Provide a means for review of EEG data, and
automatically identify and annotate events of interest
in electroencephalograph traces to aid with EEG
review. |
| Indications for Use | The REMI-AI Discrete Detection Module (REMI-AI
DDM) is indicated for the analysis of REMI Remote
EEG Monitoring System electroencephalogram
(EEG) recordings. REMI-AI DDM is intended to be
used by physicians qualified to analyze and
interpret EEG who will exercise professional
judgment in using the information.
As an aide to the qualified physician's REMI EEG
review, REMI-AI DDM marks previously acquired
sections of REMI EEG that may correspond to
neurological events of interest indicative of
potential electrographic seizures lasting at least 10
seconds in duration. REMI-AI DDM is indicated for
use with adult and pediatric patients (6+ years).
REMI-AI DDM does not mark REMI EEG records
in real time and does not provide any diagnostic
conclusion about the patient's condition to the
user. | 1. Persyst 14 EEG Review and Analysis Software is
intended for the review, monitoring and analysis of
EEG recordings made by electroencephalogram
(EEG) devices to aid neurologists in the assessment
of EEG. This device is intended to be used by
qualified medical practitioners who will exercise
professional judgment in using the information.
2. The Seizure Detection and Seizure Probability
component of Persyst 14 is intended to mark
previously acquired sections of the adult (greater
than or equal to 18 years) EEG recordings that may
correspond to electrographic seizures, in order to
assist qualified clinical practitioners in the
assessment of EEG traces. EEG recordings should
be obtained with a full scalp montage according to
the standard 10/20 system.
9. This device does not provide any diagnostic
conclusion about the patient's condition to the user. |
| Presentation of
Seizure activity | Seizure activity is marked in the EEG trace to be
viewed in an EEG viewing software | Seizure activity is marked in the EEG trace to be
viewed in an EEG viewing software |
| Physiological Signal
Acquired | Previously collected Electroencephalogram (EEG)
data collected from the scalp | Previously collected Electroencephalogram (EEG)
data collected from the scalp |
| Compatible EEG
source data | 4 channels of EEG data collected from bilateral,
bipolar scalp at both the frontal and
temporoparietal regions gathered from REMI
Sensors | Multiple channels of EEG collected from the scalp at
standard locations from a full montage according to
the standard 10/20 system |
7
Image /page/7/Picture/1 description: The image shows the word "epitel" in a bold, sans-serif font. The word is a dark blue color. There is a graphic of a heartbeat line in the middle of the word, replacing the "i". The heartbeat line is also dark blue.
8. Performance Data
Testing that verifies the performance requirements of the subject device was conducted and is included in this premarket notification, the results of which support a determination of substantial equivalence. A summary of the testing is included below:
REMI-AI DDM was tested to verify its design and to validate its safe and effective use for the intended population and use environments. Testing included the following:
Test Type | Summary |
---|---|
Software Verification | Software verification testing conducted to ensure software meets specified |
requirements | |
Clinical Validation | The algorithm was tested against a clinical reference to ensure it meets |
clinical performance requirements (as outlined in Section 11, Clinical | |
Validation | |
Human Factors Validation for REMI- | |
AI DDM outputs | REMI-AI DDM outputs were evaluated by representative epileptologist |
reviewers to validate the usability of the annotations |
REMI-AI DDM met all predetermined acceptance criteria derived from the above listed tests and demonstrated substantially equivalent performance as compared with the predicate device.
9. Clinical Study
EEG data from adult and pediatric patients was used to 1) train the REMI-AI DDM algorithm to identify potential electrographic seizure events in a broad patient population, and 2) validate the REMI-AI DDM algorithm's ability to identify potential electrographic seizure events within an indicated patient population.
Patients at these sites wore REMI wireless EEG sensors at bilateral frontal and temporoparietal scalp sites alongside standard-of-care 19-channel, full-montaqe, video-EEG for up to 7 continuous days in Epilepsy Monitoring Units (EMUs) or for up to 3 continuous days during athome ambulatory EEG monitoring.
EEG data used to generate a reference standard for REMI-AI DDM was collected from standard 19+channel wired 10-20 montage EEG records acquired concurrently with REMI 4-channel EEG. Prior to inclusion in the validation data set, all subjects' EEG records underwent panel review by 3 independent expert epileptologists. Experts consisted of a panel of 6 epileptologists, holding certification by the American Board of Psychiatry and Neurology or certification by the American Board of Clinical Neurophysiology with Special Competency in Epilepsy Monitoring. Consensus ground truth electrographic seizure negative determinations were made using the wired EEG records when at least 2 of 3 members identified the presence or absence of an electrographic seizure event.
The REMI-AI DDM validation data set consisted of 31 patient records with 87 consensusdetermined electrographic seizures lasting at least 10 seconds in duration, and 19 patient records with no consensus-determined electrographic seizures, for a total validation sample size
8
Image /page/8/Picture/1 description: The image shows the word "epitel" in a bold, sans-serif font. The word is a dark blue color. The "i" in "epitel" is stylized with a line graph that is also dark blue. The background of the image is white.
of 50. All attempts were made to ensure diverse subject demographics. The consensusdetermined electrographic seizures represented in the validation data set include:
- Focal
- . Focal Evolving to Generalized
- Generalized ●
10. Clinical Reference
EEG data used to generate a reference standard for REMI-AI DDM was collected from standard 19+channel wired 10-20 montage EEG records acquired concurrently with REMI 4-channel EEG. Prior to inclusion in the validation data set, all patients' EEG records underwent panel review by 3 independent expert epileptologists. Experts consisted of a panel of 6 epileptologists, holding certification by the American Board of Psychiatry and Neurology or certification by the American Board of Clinical Neurophysiology with Special Competency in Epilepsy Monitoring, Consensus ground truth electrographic seizures and seizure negative determinations were made using the wired EEG records when at least 2 of 3 members identified the presence or absence of an electrographic seizure event.
Training and Clinical Reference Data Overview
Demographics by age are presented in Table 10.1 below.
Age | Train | Train Sz | Train No-Sz | Test | Test Sz | Test No-Sz |
---|---|---|---|---|---|---|
Child (≤21) | 43 (40%) | 31 (42%) | 12 (34%) | 24 (48%) | 13 (42%) | 11 (58%) |
Adult (22+) | 65 (60%) | 42 (58%) | 23 (66%) | 26 (52%) | 18 (58%) | 8 (42%) |
Total | 108 | 73 | 35 | 50 | 31 | 19 |
Table 10.1. Demographics By Age. Train is the set of patient records used to train the algorithm and Test is the set of patient records used in this validation analysis. (Sz: Seizure Patients, No-Sz: Non-Seizure Patients)
Gender | Train | Train Sz | Train No-Sz | Test | Test Sz | Test No-Sz |
---|---|---|---|---|---|---|
Male | 46 (43%) | 32 (44%) | 14 (40%) | 26 (52%) | 17 (55%) | 9 (47%) |
Female | 62 (57%) | 41 (56%) | 21 (60%) | 24 (48%) | 14 (45%) | 10 (53%) |
Total | 108 | 73 | 35 | 50 | 31 | 19 |
Demographics by gender are presented in Table 10.2 below.
Table 10.2. Demographics by Gender. Train is the set of patient records used to train the algorithm and Test is the set of patient records used in this validation analysis. (Sz: Seizure Patients, No-Sz: Non-Seizure Patients)
Demographics by EEG monitoring environment are presented in Table 10.3 below.
Environment | Train | Train Sz | Train No-Sz | Test | Test Sz | Test No-Sz |
---|---|---|---|---|---|---|
EMU | 85 (79%) | 59 (81%) | 26 (74%) | 38 (76%) | 27 (87%) | 11 (58%) |
Ambulatory | 23 (21%) | 14 (19%) | 9 (26%) | 12 (24%) | 4 (13%) | 8 (42%) |
Total | 108 | 73 | 35 | 50 | 31 | 19 |
Table 10.3. Demographics by Monitoring Environment. Train is the set of patient records used to train the algorithm and Test is the set of patient records used in this validation analysis. (EMU: Epilepsy Monitoring Unit, Sz: Seizure Patients, No-Sz: Non-Seizure Patients)
9
Image /page/9/Picture/1 description: The image shows the word "epitel" in blue font. The "e" and "p" are connected, and there is a white line graph inside of the "p". The rest of the letters are not connected and are in a sans-serif font. The word is horizontally oriented and centered.
A summary of electrographic seizure types included in REMI-AI DDM training and validation is presented in Table 10.4 below.
Seizure Type | Train | Test |
---|---|---|
Focal | 254 (45%) | 22 (25%) |
Focal Evolving to Generalized | 39 (7%) | 35 (40%) |
Generalized | 269 (48%) | 30 (34%) |
Total | 562 | 87 |
Table 10.4. Electrographic Seizure Type Count. Train is the set of patient records used to train the alqorithm and Test is the set of patient records used in this validation analysis.
A summary of the duration of seizure record data, broken down by electrographic seizure type, is presented in Table 10.5 below.
Focal | Focal Evolving To Generalized | Generalized | ||||
---|---|---|---|---|---|---|
Duration (s) | Train | Test | Train | Test | Train | Test |
70% and of a False Alarm Rate (FAR) 70% (with a calculated 95% Cl lower bound of 79.5%) and FAR |