Data Exchange Standards for Clinical Neurophysiology - PhysioNet
Data Exchange Standards for Clinical Neurophysiology - PhysioNet
Data Exchange Standards for Clinical Neurophysiology - PhysioNet
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<strong>Data</strong> <strong>Exchange</strong><strong>Standards</strong> <strong>for</strong> <strong>Clinical</strong><strong>Neurophysiology</strong>Susan T. Herman, M.D.Assistant Professor of NeurologyDirector, Epilepsy Monitoring UnitPenn Epilepsy CenterUniversity of Pennsylvania
Purpose of StandardizedFormatFormatting and transmission of digitized wave<strong>for</strong>msto facilitate portable exchange between dissimilarcomputer systemsAssociated identifying and other annotative textualdata incorporated into the data streamComplete context <strong>for</strong> clinical diagnosis as well asbasic and clinical research purposes
<strong>Clinical</strong> <strong>Neurophysiology</strong><strong>Data</strong>Electroencephalograms (EEG)Magnetoencephalograms (MEG)Polysomnograms (PSG)Multiple sleep latency tests (MSLT)Evoked potentials (EP)Evoked magnetic fields (EMF)Event-related potentials (ERP)Electromyograms (EMG)Nerve conduction studies (NCS)
Common “Reader” ProgramRV - EEG ReviewDV - Digital Video ReviewPAT - Reads patient demographicsOLEV - Online event detectionDTEV - Outputs detection events to OEM databaseRSEV - Reads recording system eventsRSMNT - Reads recording system montages
AlphaTrace digitalEEGAstroMed TwinBiologic BrainAtlasBiologic CEEGraph V1Biologic CEEGraph IV, V, VI,and XLBIOMEC (via Persyst Layout)BioSemi BDFBrainLabCadwell Spectrum32Cadwell EasySystemCadwell EasyWindowsCleveland Medical Devices CrystalEEGCompumedics LimitedDigiTraceEBNeuro GaINTEuropean <strong>Data</strong> Format 90Excel Tech Ltd.GrassTelefactor AS40/CometGrassTelefactor CTEGrassTelefactor EDFRV, PAT, OLEV, RESVRV,PATRV, PATRV, PAT, RSEVRV, DV, PAT, OLEV, RSEV, RSMNTRV, PAT, OLEV, RSEV, RSMNTRV, PATRV, DV, PATRVRV, PAT, OLEV, DTEV, RSEV, RSMNTRV, PAT, OLEV, DTEV, RSEV, RSMNTRV, PAT, OLEV, RSEV, RSMNTRV, DV, PAT, OLEV, DTEV, RSEV, RSMNTRV, PATRV, PAT, OLEV, RSEVRV, PATRV, DV, PAT, OLEV, RSEV, RSMNTRVRVRV, PAT*.alpLogfile.qqq*.datE*.dat*.eeg*.lay.bdf*.sig*.00?*.log,*.eas*.eas*.crl*.raw*.w18,*.r27,*.w27*.gnt*.edf*.erd.dat.dat*.edf
GrassTelefactor TUFFGrassTelefactor TwinLexicorLifelines/Trackit/EDFMicromedNEC SynafitNervusNetwork Concepts UniquantNeuroScanNeuro <strong>Data</strong> NDFNeuroKard BrainLabNicolet AllianceWorksNicolet Alliance NTNicolet BEAMNicolet BMSI 3.0+Nicolet BravoNicolet Endeavor 3.xNicolet NicoletOne cEEGNicolet NicoletOne nEEG/LTM/MonitorRV,PATRV,PATRV, PAT, OLEV, RSEV, RSMNTRV, PAT, RSEVRV, PAT, RSEVRV, PATRV, PAT, RSEV, RSMNTRV, PAT, OLEV, RSEV, RSMNTRVRV, PATRV, DV, PATRV, PAT, RSEVRV, DV, PAT, OLEV,RSEV, RSMNTRVRVRV, DV, PAT, OLEV,RSEV, RSMNTRV, DV, PAT, OLEV,RSEV, RSMNTRV, DV, PAT, OLEV,RSEV, RSMNTRV, DV, PAT, OLEV,RSEV, RSMNT*.refLogfile.qqq*.dat*.edf*.trc*.dat*.e*.sif*.cnt*.eeg.datdata*.eegd*.*.eeg*.eeg*.xew*.one*.e
Nicolet SatelliteNicolet Satellite ESNicolet VoyagerNihonKohden 1100/2100/9100Ox<strong>for</strong>d 9200Ox<strong>for</strong>d/Teca/Medelec DG32Ox<strong>for</strong>d/Teca/Medelec Valor (Nervus)Ox<strong>for</strong>d/Teca/Medelec ProfileQSI 9X00NeuroscanRembrandt EDF <strong>for</strong>mat exportStellate Monitor/RhythmTelefactor CTE64Telediagnostic (via Persyst Layout)VanguardWalterGraphtek/Dantek PLEEGXLTech/Excel TechRV, PAT, RSEVRV, PAT, RSEVRV, PAT, OLEV, RSEV, RSMNTRV, DV, PAT, OLEV, DTEV, RSEV, RSMNTRVRV, PAT, RSEV, RSMNTRV, PAT, RSEV, RSMNTRV, PAT, RSEVRV, PATRV, PATRVRV, PATRVRV, PAT, OLEV, RSEV, RSMNTRV, PATRV, PAT, OLEVRV, DV, PAT, OLEV, RSEV, RSMNT*.dat*.ebmdata*.pnt*.**.mod*.e*.eeg*.ano*.cnt*.edf*.eeg*.dat*.layb**.wg1*.erd
Primary <strong>Data</strong>Digitized wave<strong>for</strong>ms <strong>for</strong> multiple channelsChannel identifications, sensitivities, filter settings, andsampling frequencyAveraging parameters <strong>for</strong> averaged dataDate and time of day labelsElectrode or transducer locations and attributesMeasured distancesStimulation parameters (visual, auditory, electrical, or other)Calibration dataTechnical comments or annotations created be<strong>for</strong>e or duringthe studyMedications administeredSpecial procedures per<strong>for</strong>medInstruments used
Modified 10-20 System
Evoked Potentials
Derived <strong>Data</strong>Measured feature or peak latencies, amplitudes, andother characteristicsEither automatic algorithms or technician orphysician scanResults of computer processing up the primary data(e.g. spectral analyses)Quantitative or qualitative resultsComparison to normal ranges <strong>for</strong> laboratoryText reports, interpretations, diagnoses, andrecommendations sent back to ordering physician
Computerized analysis of 2 hours of EEG shows extremely frequent seizures(status epilepticus). Each “blue bump” indicates a 3 minute seizure.A large amount of EEG data can be reviewed quickly, and nurses andphysicians who do not read EEG can easily interpret this study at the bedside
Desired FeaturesNonproprietaryInternational language supportHeader in<strong>for</strong>mation compatible with HL7Support <strong>for</strong> unlimited number of channelsChannel specific sampling rate, sensitivities, filtersettings, etc.Standardized nomenclature <strong>for</strong> electrode positionsSingle / common reference (re<strong>for</strong>matting of data)Standardized nomenclature <strong>for</strong> common annotations Provision <strong>for</strong> non-standard annotations
Desired FeaturesBinary <strong>for</strong>mat Compatible with EDF Fast retrieval and processingTime and date annotations <strong>for</strong> noncontiguous data Ability to take subsets of data (“clips”) Ability to concatenate dataProvision <strong>for</strong> data encryptionAbility to “strip” patient identifying in<strong>for</strong>mation <strong>for</strong>research purposesSmallest possible file size, few other filesOriginal uncompressed signal
TS1 (Technical Standard 1)American <strong>Clinical</strong> <strong>Neurophysiology</strong> Society MedicalInstrumentation Committee www.acns.org/guidelines.cfmAmerican Society <strong>for</strong> Testing and Materials (ASTM)Committee E-31 on Computerized Systems Subcommittee E31.16 on Interchange ofElectrophysiologic Wave<strong>for</strong>ms and Signals Revised edition was published as ASTM E 1467-94
TS1 (Technical Standard 1)Level 1: Wave<strong>for</strong>ms only Decoding of digital wave<strong>for</strong>m data and labeling ofchannelsLevel 2: Wave<strong>for</strong>ms or procedure annotations or both Wave<strong>for</strong>m data Required data elements (e.g. patient identification) Optional data elements, including site-specific dataLevel 3: Coded in<strong>for</strong>mation Associates standard alphanumeric codes with textual dataelements (e.g. ICD-9 code) Translated by receiving system into a defined text stringby means of an internal table of diagnoses (code tables) More structured and standardized medical record Facilitate automated machine processing