Validation of a brief screening instrument for the ascertainment of epilepsy.

Autor: Ottman R; G.H. Sergievsky Center and Department of Neurology, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. ro6@columbia.edu, Barker-Cummings C, Leibson CL, Vasoli VM, Hauser WA, Buchhalter JR
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2010 Feb; Vol. 51 (2), pp. 191-7. Date of Electronic Publication: 2009 Aug 19.
DOI: 10.1111/j.1528-1167.2009.02274.x
Abstrakt: Purpose: To validate a brief screening instrument for identifying people with epilepsy in epidemiologic or genetic studies.
Methods: We designed a nine-question screening instrument for epilepsy and administered it by telephone to individuals with medical record-documented epilepsy (lifetime history of >or=2 unprovoked seizures, n = 168) or isolated unprovoked seizure (n = 54), and individuals who were seizure-free on medical record review (n = 120), from a population-based study using Rochester Epidemiology Project resources. Interviewers were blinded to record-review findings.
Results: Sensitivity (the proportion of individuals who screened positive among affected individuals) was 96% for epilepsy and 87% for isolated unprovoked seizure. The false positive rate (FPR, the proportion who screened positive among seizure-free individuals) was 7%. The estimated positive predictive value (PPV) for epilepsy was 23%, assuming a lifetime prevalence of 2% in the population. Use of only a single question asking whether the subject had ever had epilepsy or a seizure disorder resulted in sensitivity 76%, FPR 0.8%, and estimated PPV 66%. Subjects with epilepsy were more likely to screen positive with this question if they were diagnosed after 1964 or continued to have seizures for at least 5 years after diagnosis.
Discussion: Given its high sensitivity, our instrument may be useful for the first stage of screening for epilepsy; however, the PPV of 23% suggests that only about one in four screen-positive individuals will be truly affected. Screening with a single question asking about epilepsy yields a higher PPV but lower sensitivity, and screen-positive subjects may be biased toward more severe epilepsy.
Databáze: MEDLINE
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