Superior reproducibility and repeatability in automated quantitative pupillometry compared to standard manual assessment, and quantitative pupillary response parameters present high reliability in critically ill cardiac patients

• Published in: PloS one Vol. 17; no. 7; p. e0272303
• Main Authors: Nyholm, Benjamin, Obling, Laust, Hassager, Christian, Grand, Johannes, Møller, Jacob, Othman, Marwan, Kondziella, Daniel, Kjaergaard, Jesper
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 28.07.2022; Public Library of Science (PLoS)
• Subjects: Agreements; Automation; Bias; Biology and Life Sciences; Cardiac arrest; Cardiac patients; Coma; Comparative analysis; Component reliability; Confidence intervals; Correlation; Correlation coefficient; Correlation coefficients; Critically ill; Engineering and Technology; Health aspects; Heart; Latency; Medicine and Health Sciences; Nurses; Parameters; Patient assessment; Patients; Prognosis; Pupil (Eye); Pupil size; Pupillometry; Reliability analysis; Reproducibility; Research and Analysis Methods; Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0272303

Quantitative pupillometry is part of multimodal neuroprognostication of comatose patients after out-of-hospital cardiac arrest (OHCA). However, the reproducibility, repeatability, and reliability of quantitative pupillometry in this setting have not been investigated. In a prospective blinded validation study, we compared manual and quantitative measurements of pupil size. Observer and device variability for all available parameters are expressed as mean difference (bias), limits of agreement (LoA), and reliability expressed as intraclass correlation coefficients (ICC) with a 95% confidence interval. Fifty-six unique quadrupled sets of measurement derived from 14 sedated and comatose patients (mean age 70±12 years) were included. Automated quantitative pupillometry has excellent reliability and twice the reproducibility and repeatability than manual pupillometry. This study further presents novel estimates of variability for all quantitative pupillary response parameters with excellent reliability.