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Record W4412123712 · doi:10.1002/epi4.70099

Detection of focal impaired awareness seizures using a biometric shirt

2025· article· en· W4412123712 on OpenAlex
Jérôme St‐Jean, Oumayma Gharbi, Dènahin Hinnoutondji Toffa, Thi Phuoc Yen Tran, Manon Robert, Dang Khoa Nguyen, Elie Bou Assi

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueEpilepsia Open · 2025
Typearticle
Languageen
FieldNeuroscience
TopicEEG and Brain-Computer Interfaces
Canadian institutionsUniversité de MontréalCentre Hospitalier de l’Université de Montréal
FundersNatural Sciences and Engineering Research Council of CanadaInstitut TransMedTechCanadian Institutes of Health ResearchFonds de Recherche du Québec - SantéInstitut de Valorisation des Données
KeywordsBiometricsPsychologyComputer securityComputer science

Abstract

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OBJECTIVE: In recent years, seizure detection using wearable technology has gained significant attention in research. Most studies, however, have focused on detecting generalized or focal to bilateral tonic-clonic seizures. This study evaluates the feasibility of using a biometric shirt to detect focal impaired awareness seizures (FIAS) by monitoring respiratory, electrocardiography, and accelerometry signals. METHODS: Patients with epilepsy were recruited at the University of Montreal Hospital Center epilepsy monitoring unit. Seizures were annotated by epileptologists based on simultaneous video-electroencephalographic recordings, blinded to the shirt data. Features were extracted from the respiratory, accelerometry, and electrocardiography signals using varying window sizes and steps. An XGBoost classifier was trained and tested using a nested leave-one-subject-out cross-validation. Post-processing included a firing power regularization method to reduce false alarms. RESULTS: We recorded 113 FIAS from 27 patients who wore the shirt continuously for over 4750 hours. Using a firing power threshold of 0.65, we detected 71 seizures, resulting in a mean sensitivity of 66%, a 15% time in warning, and a false alarm rate (FAR) of 30 per 24 hours. A firing power threshold of 0.85 allowed us to reduce false alarms (8% time in warning, FAR of 21 per 24 hours) but resulted in a lower sensitivity of 57%. Performances varied across patients: sensitivity was high and FAR was low for some patients and vice versa for others, indicating variability in algorithm effectiveness across patients. SIGNIFICANCE: Our results demonstrate that detecting FIAS with a connected shirt could be feasible for certain patients, although the rate of false alarms remains an issue. Designing a personalized algorithm and selecting patients who exhibit significant physiological changes during seizures could make wearable-based FIAS detection more viable in the near future. PLAIN LANGUAGE SUMMARY: Novel mobile health technologies could transform epilepsy care by enabling continuous monitoring of seizures in everyday life. In this study, we used a biometric shirt to detect seizures with impaired awareness automatically. We used the shirt to measure breathing, heart activity, and movement in 27 patients with epilepsy in a hospital setting. Our algorithm detected up to two-thirds of seizures correctly. However, the number of incorrect alarms remains relatively high, with variable performances between patients. While the technology showed potential, these challenges highlight the need for further improvements and personalized care plans.

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Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: Bench or experimental
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.027
Threshold uncertainty score0.465

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.002
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.001
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.071
GPT teacher head0.357
Teacher spread0.286 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it