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Objective
This study was undertaken to develop a multimodal machine learning (ML) approach for predicting incident depression in adults with epilepsy.
Methods
We randomly selected 200 patients from the Calgary Comprehensive Epilepsy Program registry and linked their registry‐based clinical data to their first‐available clinical electroencephalogram (EEG) and magnetic resonance imaging (MRI) study...
Objective
There are no clinical guidelines dedicated to the treatment of epilepsy in older adults. We investigated physician opinion and practice regarding the treatment of people with epilepsy aged 65 years or older. We also sought to study how our opinion and practice varied between geriatricians, general neurologists, and epilepsy neurologists (i.e., epileptologists).
Methods
We initially piloted...
Epilepsy surgery is the treatment of choice for patients with drug‐resistant seizures. A timely evaluation for surgical candidacy can be life‐saving for patients who are identified as appropriate surgical candidates, and may also enhance the care of nonsurgical candidates through improvement in diagnosis, optimization of therapy, and treatment of comorbidities. Yet, referral for surgical evaluations...
Objective
We aimed to assess the reliability and validity of single‐item global ratings (GR) of satisfaction with epilepsy surgery.
Methods
We recruited 240 patients from four centers in Canada and Sweden who underwent epilepsy surgery ≥1 year earlier. Participants completed a validated questionnaire on satisfaction with epilepsy surgery (the ESSQ‐19), plus a single‐item GR of satisfaction with...
Objective
The relationship between antiseizure medications (ASMs), which improve health outcomes by controlling seizures, and health‐related quality of life (HRQOL) is poorly understood and may involve intermediate variables. We evaluated the potential mediators of the association between ASMs and HRQOL.
Methods
Data are from an outpatient registry of adult patients with epilepsy seen at the Foothills...
Objectives
Patient‐reported outcome measures (PROMs) are used widely to elicit patient's self‐appraisal of their health status and quality of life. One fundamental assumption when measuring PROMs is that all individuals interpret questions about their health status in a consistent manner. However, subgroups of patients with a similar health condition may respond differently to PROM questions (ie,...
Objective
The 19‐item Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19) is a validated and reliable post hoc means of assessing patient satisfaction with epilepsy surgery. Prediction models building on these data can be used to counsel patients.
Methods
The ESSQ‐19 was derived and validated on 229 patients recruited from Canada and Sweden. We isolated 201 (88%) patients with complete clinical...
Objective
This study was undertaken to identify clusters of adult onset epilepsy with distinct comorbidities and risks of early and late death.
Methods
This was a retrospective open cohort study that included all adults meeting a case definition for epilepsy after the Acceptable Mortality Recording date in the Health Improvement Network database for the years 2000–2012 inclusive. Unsupervised agglomerative...
Objective
This study was undertaken to investigate the distribution of social, lifestyle/behavior, and chronic disease risk factors for cardiovascular disease (CVD) in people with epilepsy as compared to the general population. We also measured the cross‐sectional association between epilepsy and CVD in older adults, with and without adjustments for a history of stroke.
Methods
We analyzed data...
Precision medicine can be distilled into a concept of accounting for an individual’s unique collection of clinical, physiologic, genetic, and sociodemographic characteristics to provide patient‐level predictions of disease course and response to therapy. Abundant evidence now allows us to determine how an average person with epilepsy will respond to specific medical and surgical treatments. This is...
Objective
To assess the relative contribution of ictal subtraction single‐photon emission computed tomography (ISSPECT) and 18F‐fluorodeoxyglucose positron emission tomography computed tomography (PET) in epilepsy surgery decision making.
Materials and methods
A retrospective 3‐year study of consecutive patients with resistant focal epilepsy who underwent ISSPECT and PET to evaluate to what extent...
Objective
To use clinically informed machine learning to derive prediction models for early and late premature death in epilepsy.
Methods
This was a population‐based primary care observational cohort study. All patients meeting a case definition for incident epilepsy in the Health Improvement Network database for inclusive years 2000‐2012 were included. A modified Delphi process identified 30 potential...
Objective
No validated tools exist to assess satisfaction with epilepsy surgery. We aimed to develop and validate a new measure of patient satisfaction with epilepsy surgery, the 19‐item Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19).
Methods
An initial 31‐item measure was developed based on literature review, patient focus groups, thematic analysis, and Delphi panels. The questionnaire...
Objective
To apply unsupervised machine learning to patient‐reported outcomes to identify clusters of epilepsy patients exhibiting unique psychosocial characteristics.
Methods
Consecutive outpatients seen at the Calgary Comprehensive Epilepsy Program outpatient clinics with complete patient‐reported outcome measures on quality of life, health state valuation, depression, and epilepsy severity and...
Objective
To evaluate the efficacy and tolerability of antiepileptic drugs (AEDs) in elderly individuals with epilepsy.
Methods
We searched four electronic databases as well as bibliographies and conference abstracts. Published and unpublished, randomized, or quasirandomized trials reporting the use of AEDs in people aged at least 60 years with epilepsy were eligible for inclusion. Two authors...
Objective
Drug shortages are occurring at an increasing rate. From May to October 2016, there was a shortage of a level I critical antiepileptic drug, clobazam. We aimed to study the impact of this shortage on patients with epilepsy.
Methods
Adult patients from Calgary's Comprehensive Epilepsy Program who were taking clobazam were approached to participate in the study. Baseline data from the clinic...
Objective
Preliminary evidence suggests that serotonin reuptake inhibitor (SRI) use may increase postictal respiratory drive and prevent death. We sought to determine whether SRIs are associated with improved all‐cause and possible seizure‐specific mortality in patients with epilepsy.
Methods
Patients with epilepsy and a random 10:1 sample without epilepsy were extracted from The ClinicAl research...
Objective
The aim of this study was to examine the impact of seizures on persons living with epilepsy in a national, community‐based setting.
Methods
The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), a cohort derived from a national population‐based survey of noninstitutionalized persons aged 15 or more years. Participants had to be on a seizure drug or to...
Clinical decision rules (CDRs) have been empirically demonstrated to improve patient satisfaction and enhance cost-effective care. The use of CDRs has not yet been robustly explored for epilepsy. We performed a systematic review of MEDLINE (from 1946) and Embase (from 1947) using Medical Subject Headings and keywords related to CDRs and epilepsy. We included original research of any language deriving,...
Objective
Elderly onset epilepsy represents a distinct subpopulation that has received considerable attention due to the unique features of the disease in this age group. Research into this particular patient group has been limited by a lack of a standardized definition and understanding of the attributes associated with elderly onset epilepsy.
Methods
We used a prospective cohort database to examine...
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