• William M McDevitt, Laura Quinn, Peter R Bill, Kevin P Morris, Barnaby R Scholefield, and Stefano Seri.
• Department of Neurophysiology, Birmingham Women's and Children's NHS Foundation Trust, UK. Electronic address: w.mcdevitt@nhs.net.
• Clin Neurophysiol. 2021 Mar 1; 132 (3): 765-769.

ObjectiveTo measure inter- and intra-rater agreement in the interpretation of cortical somatosensory evoked potential (SSEP) components following paediatric cardiac arrest (CA) in multi-professional neurophysiology teams.MethodsThirteen professionals blinded to patient outcome interpreted 96 SSEPs in paediatric patients 24-/48-/72-hours following CA. Of these, 34 were duplicates used to assess intra-rater agreement. Consistent interpretations (absent/present/indeterminate) between scientists (who record/identify SSEP components) and neurophysiologists (who provide prognostic SSEP interpretation) were expressed as percentages. Rates of agreement were calculated using Fleiss' kappa coefficient (K).ResultsUnanimous agreement between professionals was present in 40% (95%CI: 28-54%) of the interpreted SSEPs, with a K value of 0.62 (95%CI: 0.55-0.70) based on average agreement. Agreement was similar between neurophysiologists (K = 0.67; 95%CI: 0.57-0.77) and scientists (K = 0.62; 95%CI: 0.54-0.70) but lower in patients < 2 years old (K = 0.23; 95%CI: 0.14-0.33) and in those with poor outcome (K = 0.21; 95%CI: 0.07-0.35). No SSEP was unanimously interpreted as absent and 92% (95%CI: 89-95%) of duplicate SSEPs were interpreted consistently.ConclusionDespite substantial agreement when interpreting prognostic SSEPs, this was significantly lower in children with poor outcome and of younger age.SignificanceClinicians using SSEPs in the intensive care unit should be aware of the inter-rater variability when interpreting SSEPs as absent.Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.

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