Holberg EEG Brochure

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SCORE EEG® Premium Edition

Holberg EEG and the SCORE EEG® Premium Edition software replaces free text EEG reporting, and introduces systematic computer based classification

SCORE EEG®Premium Edition •

Easy to use annotation tool that guides the user to a standardised EEG report in just a few clicks.

Offers quality enhancements through standardised EEG interpretations and transparent communication of the results to the referral physician.

Building on its database and multi-lingual support, SCORE EEG Premium Edition offers great possibilities for international sharing of results, research and education.

This is the first software available building on the new international endorsed terminology for reporting of EEG, called SCORE (Standardised Computer-based Organised Reporting of EEG). SCORE EEG supports linkage to the EEG reader software and your Electronic Health Record system (EHR). This allow for a seamless efficient workflow and generates a clean standardised EEG report.

THE CHALLENGE The electroencephalography (EEG) signal has a high complexity, and the process of extracting clinically relevant features has traditionally been achieved by visual inspection of the recordings and reports designed in free text format. Free text in medical reporting is challenging as it induces variation in the descriptions and two physicians might describe the exact same finding in different wording and with personal style. This can create a barrier between the expert, referring physician and patients. In addition, free text reporting makes information inaccessible for statistical analysis which would be of great interest for research and educational purposes. With these challenges in mind the IFCN (International Federation of Clinical Neurophysiology) established a SCORE taskforce with the support of ILAE (International League Against Epilepsy) aiming to standardise EEG reporting.

SCORE STANDARD The SCORE consortium is an IFCN official taskforce, with the support of ILAE, and consists of more than 40 experts and key opinion leaders in various fields of EEG, covering Europe, US, Canada and Asia. The target for the consortium has been to establish a computer based system for EEG reporting and classification, where the physician can construct the report based on predefined terms and elements for each EEG feature as well as clinical phenomena. IFCN supports the global SCORE consensus published in Clinical Neurophysiology and a chapter on SCORE can be found in the newest edition of Niedermeyer’s Electroencephalography, the leading educational and reference book on EEG. IFCN has included SCORE in the revised EEG guidelines as well as their updated glossary.

THE SOLUTION SCORE EEGÂŽPremium Edition is the first software application building on the new medical standard, SCORE. It offers quality enhancements in your EEG reporting, improves the overall clinical workflow, and strengthens your educationaland research opportunities.

QUALITY DESCRIBE YOUR EEG AS THE EXPERTS The SCORE standard has been endorced by IFCN and ILAE. Reporting and classification is based on standardiced terminology determined by the leading EEG expert. Now you can describe your EEGs like the experts. GUIDED REPORTING SCORE EEG Premium Edition guides the user to create an EEG report while still having full control on the findings. An implemented logic will only present you with the relevant options and features, and leave out irrelevant information. STRUCTURED REPORTING SCORE EEG generates a clean and clear report, based on predefined terms and classifications, which includes visualization on a head model. This will provide the referring physicians with a better understanding of the final report that can be communicated to the patient. TRANSPARENT REPORTING The implemented bookmark functionality lets you connect your EEG descriptions in the SCORE EEG application with the corresponding examples in the EEG. This is a unique feature that validates the assessment and lets you document your decisions.

RESEARCH GET ACCESS TO YOUR EEG DATA EEG reports will be stored locally in a hospital database. The data is easy accessible, both for hospital quality measures, administrative overview, educational presentations, and research by using the integrated search tool. COLLABORATE AND SHARE Multi language supports will provide opportunities for collaborations and research previously not possible. EEG reports are translated by a single mouse-click. FUTURE OPPORTUNITIES The database structure and the systematic reporting in SCORE EEG allows for anonymized data to be shared in national- and international EEG databases. Wouldn’t it be great to export your anonymized data to other statistical programs as STATA and SPSS? These future features are just some of the possibilities that lies ahead when we all start SCOREing EEGs.


The SCORE EEG Educational Platform is an interactive web-based software where the user can create an EEG-report and compare with the report from an expert. Unlike textbooks and articles, the SCORE EEG Educational Platform offers live examples of EEG studies and findings where you can create your own EEG-report using SCORE, the new global reporting standard for EEG. The Educational Platform contains a large selection of studies and findings covering various fields of EEG and allows you to search and browse for live examples of specific findings.

• • • • •

Practice your EEG-reporting skills in a safe and realistic environment. Get instant feedback on your reporting. See live examples of findings. Learn how to use SCORE, the new global standard for EEG reporting. Access the Educational Platform online.

With the SCORE EEG Educational Platform, we see great opportunities for hospitals and clinics, students and experienced physicians, to learn how to use the SCORE standard and to take advantage of the opportunities that go along with standardised EEG reporting. SCORE offers quality enhancement in your EEG reporting, strengthens your educational- and research opportunities, and opens up for international sharing of results.

For more info:

EEG report

04/25/2016 10:45

Ømt Unit Name 1:'.:t lnstitution Name 123 Test Avenue � 732-757-12345

HOSPITAL{(t) LOGO �.,.....,;o,,<I'>'

REFERRAL FROM Name lnstitution Address

PATIENT - PERSONAL INFORMATION Dr.John Doe Local Test Hospital 300 Example Avenue 9810 Testplace


Name ldentity string Date of birth Gender Age at study time

Jane Doe 041100 12345 04/11/2000 Female 15 years

Study Id 32. Local study id 2261x04. Technicion Tech Nologist. Start 04/25/2016 09:46. Stop 04/25/2016 10:16. Recorded 30 minutes. EEG type lndicotion for EEG Sensor group

Sleep deprived EEG Clinical suspicion of epilepsy 10-20 and inferior row

MODULATORS/PROCEDURES Hyperventilation Properties: Good effort of hyperventilation.

lntermittent photic stimulation FINDINGS Background activity Posterior dominant rhythm Properties: 9-10 Hz. Medium amplitude (20-70µV). Symmetrical amplitude. Reactive to eye opening. Symmetrical frequency.

Sleep and drowsiness Normal sleep pattern Properties: Sleep stage 1 (N1). Sleep stage 2 (N2).

lnterictal findings Epileptiform interictal activity /vlorphology: Polyspike-and-slow-wave. Location: Bilateral and midline frontal, central. Symmetrical amplitude. Primary bilateral synchronous activity. Time-reloted features: Rhythmic trains or bursts 4-5 Hz. Duration: 1-3 seconds. /vlodulotors: lncreased during hyperventilation. lncreased during sleep.

Episodes Generalized myoclonic seizure Timing & context: Consciousness not tested.ls aware of the episode. Simultaneous clinical and EEG start.

Semiology Myoclonic

Somatotopic modifiers: Symetric. Arm. Leg.


letal EEG activity

/vlorphology: Polyspikes. Location: Bilateral and midline frontal. Symmetrical amplitude. Primary bilateral synchronous activity.

Polygraphic channels ECG

Properties: Norma I activity.

CONCLUSION SUM MARY OF THE FINDINGS Myoclonicjerks with EEG correlate (polyspikes). Bilateral synchronous, 4-5 Hz, polyspike-and-slow-wave interictal epileptiform activity.

DIAGNOSTIC SIGNIFICANCE Abnormal recording supporting: Juvenile myoclonic epilepsy.

Tech Nologist Technician Jane Doe

0ne Doc

Two Doc

Physician (signed)

Supervising physician

041100 12345




)·1/·. 1t ''







Epileptiform abnormality Other abnormal activity Page

1 /1

WORKFLOW The Linkage between the EEG reader and the SCORE EEG application allows for: • Automated transfer of patient demographics and EEG modulators. • Automated detection of Events listed in the EEG reader. • Create bookmark of findings in the EEG with the description in the SCORE EEG application. • Improved overview of findings and descriptions. • Improves educational aspect as descriptions are linked to your EEG recordings.

Internal Workflow

Electronic Health Record (EHR)

EEG Reader linkage

SCORE EEG® Premium Edition

In order to SCORE your EEGs time efficiently and optimized for your clinical workflow, Holberg EEG recommend setting up a direct integration between SCORE EEG and your Electronic Health Record system (EHR).

Once a senior physician has signed off the EEG report, the comprehensive report is automatically transferred and immediately accessible in the EHR. The integration is based on a HL7 interface and can be provided by Holberg as a separate module.

ROLES AND ADMINISTRATION Assign separate roles and level of administration.

SCREENSHOT Take a screenshot of the findings and add it to the final report with one single click.

MULTIPLE SITE SETUP Install multiple databases from different satellite sites. You can then report everything at the main site and you’ll have a clear overview of where the EEGs are recorded with individual worklists.

FREE TEXT In order to preserve some of the autonomy in the reporting, the application allows for free text entries, but only in addition to the SCORE terminology, and not instead of. The free text will be stored in the database.

MULTI LANGUAGE SUPPORT Collaborate globally with the multi language support. Translate the report by a single click. Please contact us for available languages.

The referring physicians gave much positive feedback about the structure of the report, especially the graphic representation of the abnormalities on the “head-model” (Sándor Beniczky, Danish Epilepsy Centre)

CORE FUNCTIONALITY GENERAL EEG Description of General routine EEGs. LONG TERM MONITORING (LTM) The LTM study can last for several days, and the EEG system often split the recordings into several files. SCORE EEG can handle multiple recordings for each study and merge them into one study so that the user will not have to keep track on the separate files where specific findings occur. Findings for all recordings are summarized in one report. INTENSIVE CARE UNIT EEG (ICU) Offers the same advantage as for LTM monitoring but with even one more abstraction level where the user can report independent on recordings but rather within a certain time period. Includes the terminology for ICU reporting based on the Hirsh terminology (Rhythmic and periodic patterns in critical ill patients). NEONATAL EEG Includes the new SCORE terminology synchronized with the “ACNS Standardized EEG Terminology and Categorization for the Description of Continuous EEG Monitoring in Neonates “.

ABOUT US Holberg EEG AS is a Norwegian based eHealth company with products for standardised structural interpretation, reporting and sharing of advanced diagnostic data, and is currently focused in the field of Electroencephalography (EEG). EEG measures electrical brain activity and is mostly used in the diagnosis and follow-up of patients with epilepsy, coma and dementia. The company is owned by Televenture/ Norsk Innovasjonskapital IV AS, the founders and a set of local investors as well as company employees. The founders of Holberg EEG Dr. Harald Aurlien and Dr. Jan Brøgger are both consultants in clinical neurophysiology at Haukeland University Hospital. As of 1998, Dr. Harald Aurlien developed the first published systematic computer based program for reporting of EEG. (Aurlien H et al, 1999. A new way of building a database of EEG findings. Clin Neurophysiol 110:986–995). Dr. Aurlien’s PhD thesis in 2008 was based on the development and use of this system, which has been a model for the development of the SCORE system.

PLEASE CONTACT HOLBERG EEG FOR DEMO Please contact Holberg EEG in order to receive a trial version of the SCORE EEG Premium Edition. www.holbereeg.com info@holbergeeg.com Phone: + 47 21 51 91 11

Holberg EEG Møllendalsveien 65 C 5009 BERGEN, Norway E-mail: info@holbergeeg.com Phone: +47 21 51 91 11

The SCORE EEG Premium software is not intended for use as a diagnostic aid or a clinical decision tool. The SCORE EEG software does not suggest a diagnosis or suggest a certain course of action. The SCORE EEG software does not measure, calculate represent or modify raw EEG data originating from the EEG reader software. For a detailed description of the intended use of SCORE EEG Premium Edition, please refer to the Instruction for Use. SCORE EEG ® is a registered trademark by Holberg EEG in EU, Norway, China, USA and Canada.


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