Automated spike detection: Which software package?

•Persyst has the highest sensitivity (95%), together with reasonable specificity.•Interrater agreement for Persyst and Encevis are similar to human review.•This report can help prospective users choose a software package. We assessed three commercial automated spike detection software packages (Persyst, Encevis and BESA) to see which had the best performance. Thirty prolonged EEG records from people aged at least 16 years were collected and 30-minute representative epochs were selected. Interictal epileptiform discharges (IEDs) were marked by three human experts and by all three software packages. For each 30-minutes selection and for each 10-second epoch we measured whether or not IEDs had occurred. We defined the gold standard as the combined detections of the experts. Kappa scores, sensitivity and specificity were estimated for each software package. Sensitivity for Persyst in the default setting was 95% for 30-minute selections and 82% for 10-second epochs. Sensitivity for Encevis was 86% (30-minute selections) and 61% (10-second epochs). The specificity for both packages was 88% for 30-minute selections and 96%-99% for the 10-second epochs. Interrater agreement between Persyst and Encevis and the experts was similar than between experts (0.67–0.83 versus 0.63–0.67). Sensitivity for BESA was 40% and specificity 100%. Interrater agreement (0.25) was low. IED detection by the Persyst automated software is better than the Encevis and BESA packages, and similar to human review, when reviewing 30-minute selections and 10-second epochs. This findings may help prospective users choose a software package. [Display omitted] .