Scalp EEG seizure warning in children under a pre-specified, locked evaluation: confound audit, structured chance levels and a negative result

Reported performance of scalp electroencephalographic (EEG) seizure prediction is often inflated by lenient evaluation and by the vigilance-state, clock-time and admission-trend structure of monitoring data. We asked how much short-horizon warning survives a pre-specified, locked evaluation. Continuous video-EEG from 21 monitored children (1315 h) formed the development cohort. A statistical-process-control warning method, evaluated under a written protocol, detected 44% of evaluable seizures at 0.48 false alarms per hour, no better than a random predictor (51%, p = 0.86); its statistic moved

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