RELIABILITY OF SEIZURE CLASSIFICATION USING A SEMISTRUCTURED INTERVIEW
RELIABILITY OF SEIZURE CLASSIFICATION USING A SEMISTRUCTURED INTERVIEW
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DOI：
10.1212/wnl.43.12.2526
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发表时间：
1993-12-01
期刊：
影响因子：
9.9
通讯作者：
SCHEUER, ML
中科院分区：
文献类型：
--
作者：
OTTMAN, R;LEE, JH;SCHEUER, ML
癫痫发作的标准化分类方法对临床实践和流行病学研究都具有重要意义。在这项研究中，我们开发了一种使用半结构化电话访谈和操作诊断标准的标准化分类策略。我们采访了1,957名从志愿组织确定的成人癫痫患者。为了确认和扩大癫痫发作史，我们还采访了67%的受试者的一级亲属，并获得了59%的患者的医疗记录。三名外行审查员利用所有可用信息对癫痫发作进行分类。为了评估可靠性，每个审稿人将分配给其他人的受试者样本进行分类。此外，一位专家医师对分配给两位审稿人的受试者样本进行了分类。对于广泛性癫痫发作的一致性为“中度-实质性”，无论是在两组外行审查员之间的比较，还是在神经科医生与外行审查员之间的比较。对于部分发作性癫痫，无论是对外行审查员还是神经科医生与外行审查员之间的一致性都是“实质上几乎完美的”。这些结果表明，癫痫发作可以可靠地分类外行审查员，使用操作标准适用于在半结构化电话访谈中确定的症状。
Methods for standardized classification of epileptic seizures are important for both clinical practice and epidemiologic research. In this study, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria. We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the seizure history, we also interviewed a first-degree relative for 67% of subjects and obtained medical records for 59%. Three lay reviewers used all available information to classify seizures. To assess reliability, each reviewer classified a sample of subjects assigned to the others. In addition, an expert physician classified a sample of subjects assigned to two of the reviewers. Agreement was ''moderate-substantial'' for generalized-onset seizures, both for the comparisons between pairs of lay reviewers and for the neurologist versus lay reviewers. Agreement was 'substantial-almost perfect' for partial-onset seizures, both for pairs of lay reviewers and for the neurologist versus lay reviewers. These results suggest that seizures can be reliably classified by lay reviewers, using operational criteria applied to symptoms ascertained in a semistructured telephone interview.