Phone Videos Help Doctors Spot Infantile Spasms Earlier

What was studied

This study looked at whether clinicians could recognize infantile epileptic spasms from smartphone videos, and whether a short teaching session plus clinical history would improve accuracy. Infantile epileptic spasms syndrome (IESS) is a time-sensitive epilepsy condition in babies, and delays in diagnosis and treatment are associated with worse neurodevelopmental outcomes.

The study was done at multiple centers around the world in 2022 to 2023. A total of 180 clinicians and trainees from different specialties were included. They watched 9 smartphone videos of children from the United States and South Africa: 6 videos showed EEG-confirmed infantile epileptic spasms, and 3 showed non-epileptic conditions that can look similar. Participants judged the videos 3 times: first with video alone, then after brief IESS education, and then with added clinical history.

What they found

At the start, clinicians were correct about 64% of the time. After the brief training and clinical history were added, accuracy improved to 72%. After video plus training plus history, sensitivity was 0.85, meaning participants identified many of the true spasm cases.

The odds of making the correct diagnosis increased by 86% after training and history were added. Clinicians also reported higher diagnostic confidence and greater comfort treating epileptic spasms without an EEG, with both measures improving on 5-point rating scales. Staff physicians were more accurate than trainees, with a 24% higher likelihood of making a correct diagnosis.

Limits of the evidence

This study tested clinicians using a small set of only 9 videos, so it may not reflect the full range of how spasms or look-alike events appear in real life. The videos came from only 2 countries, and the results may not apply equally in all settings.

This was not a study of real patient outcomes, so it cannot show that using smartphone videos actually leads to faster treatment or better development. It also does not show that video can replace an EEG. The improvement in comfort treating without EEG does not show that this approach is always safe or appropriate.

For families and caregivers

This study suggests that parent-recorded smartphone videos may help clinicians recognize infantile spasms sooner, especially when EEG access is delayed. The authors suggest this could help with triage in a condition where time matters.

For families, the main message is that a clear video of concerning movements may be useful to show a clinician. But video alone is not perfect, and this study does not show that videos should replace a full medical evaluation or EEG when available.

What to watch next

Stronger evidence would come from studies showing whether using parent videos in real clinics shortens time to diagnosis and treatment and affects outcomes for babies.

Terms in this summary

infantile epileptic spasms syndrome

A serious epilepsy condition in babies that causes brief seizures called spasms and is associated with developmental problems.

EEG

A test that records the brain's electrical activity and can help diagnose seizures.

triage

Sorting patients by how urgent their problem may be and what care they need first.

sensitivity

How well a test or method finds people who truly have the condition.

clinical history

Information about symptoms, timing, and past health that helps a clinician make a diagnosis.

diagnostic accuracy

How often a diagnosis is correct.