Reply to the comment on the article: Reduction of the acquisition time needed to obtain somatosensory evoked potentials by estimation of the required averaging sweep count by an algorithm

This response addresses comments regarding the methodology of somatosensory evoked potential (SEP) monitoring and clarifies the objectives and limitations of the proposed sweep-count reduction algorithm. The primary aim of the study was not to minimize sweep counts indiscriminately across all patients, but rather to investigate whether specific patients could be identified in whom a safe reduction of sweep counts is feasible under stable intraoperative conditions. Given the dynamic nature of the surgical environment and the potential for rapid changes in patient physiology, adaptability remains a fundamental requirement for SEP monitoring.

The findings demonstrate that sweep-count reduction can, in principle, accelerate SEP acquisition without compromising monitoring quality during periods of physiological stability. However, the study was not designed to establish a universal clinical protocol. The authors emphasize that the algorithm requires further validation in broader patient populations, including individuals with preexisting neurological disorders, significant comorbidities, and those undergoing different types of surgical procedures. Consequently, no direct clinical recommendations should be derived from the current findings alone.

The importance of waveform morphology assessment is also acknowledged. While the present study focused on the feasibility of sweep-count reduction, future investigations will specifically evaluate potential SEP waveform deformations associated with reduced sweep numbers. Morphological waveform analysis will be incorporated into ongoing algorithm refinement and validation efforts to ensure that signal integrity is maintained despite modifications to acquisition parameters.

The authors further note that the development process remains ongoing and includes additional algorithm optimization, machine-learning implementation, and comprehensive clinical evaluation. Ultimately, automated approaches are intended to support, rather than replace, expert interpretation. Careful assessment of SEP recordings by experienced neurophysiologists and anesthesiologists remains essential for ensuring patient safety and maintaining the reliability of intraoperative neurophysiological monitoring.

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