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February 1989

The Art of Turf Creation-Reply

Author Affiliations

Department of Psychiatry NYU Medical Center 550 First Ave New York, NY 10016

Arch Gen Psychiatry. 1989;46(2):194. doi:10.1001/archpsyc.1989.01810020096018

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In Reply.—  Many confounding issues are raised by Dr Nuwer. Several facts can be stated plainly. First, quantitative electrophysiologic assessment of brain activity and its mapping are not merely the computerization of the EEG. Such statements are at best disingenuous. Second, there are real problems of artifact recognition and rejection. Yet, computer test-retest interpretation is at least as good as interrater reliability among electroencephalographers. Third, there are genuine concerns about certification and privileging that will not be resolved except within the appropriate disciplines. This technology holds promise not only for psychiatry and neurology, but for neurosurgery, ophthalmology, otolaryngology, and cardiovascular surgery as well. Many of the skills necessary for intraoperative monitoring are different from those necessary for assessing psychiatric patients. This should be obvious.It is true that some psychiatrists may misuse this technology to generate fees. It is also true that some electroencephalographers perform repeated unnecessary EEGs on learning-disabled and

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