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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2005

01-06-2005 | Systematic Review

Are somatosensory evoked potentials the best predictor of outcome after severe brain injury? A systematic review

Authors: B. G. Carter, W. Butt

Published in: Intensive Care Medicine | Issue 6/2005

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Abstract

Objective

Many tests have been used to predict outcome following severe brain injury. We compared predictive powers of clinical examination (pupillary responses, motor responses and Glasgow Coma Scale, GCS), electroencephalography (EEG) and computed tomography (CT) to that of somatosensory evoked potentials (SEPs) in a systematic review.

Materials and methods

Medline (1976–2002) and Embase (1980–2002) were searched, manual review of article reference lists was conducted, and authors were contacted. We selected 25 studies addressing the prediction of outcome after severe brain injury using SEPs and either GCS, EEG, CT, pupillary or motor responses. Outcomes were determined for patients with normal or bilaterally absent SEPs and graded measures of GCS, EEG, CT, pupillary responses or motor responses. For favourable outcome prediction SEPs were superior in sensitivity, specificity and positive and negative predictive values, except for pupillary responses which had superior sensitivity and GCS which had higher specificity. SEPs had superior summary receiver operating characteristic curves, with the exception of motor responses, and superior ratio of odds ratios. For unfavourable outcome prediction SEPs were superior to the other tests in sensitivity, specificity and positive and negative predictive values, except for motor and pupillary responses, GCS and CTs which had superior sensitivity. All SEP summary receiver operating characteristic curves and pooled ratio of odds ratios were superior.

Conclusions

Although imperfect, SEPs appear to be the best single overall predictor of outcome. There is sufficient evidence for clinicians to use SEPs in the prediction of outcome after brain injury.
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Metadata
Title
Are somatosensory evoked potentials the best predictor of outcome after severe brain injury? A systematic review
Authors
B. G. Carter
W. Butt
Publication date
01-06-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2633-1

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