Global assessment of the severity of epilepsy (GASE) Scale in children: Validity, reliability, responsiveness
Global assessment of the severity of epilepsy (GASE) Scale in children: Validity, reliability, responsiveness
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DOI：
10.1111/epi.13216
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发表时间：
2015-12-01
期刊：
影响因子：
5.6
通讯作者：
Speechley, Kathy Nixon
中科院分区：
文献类型：
--
作者：
Chan, Cindy Jauhrur;Zou, Guangyong;Speechley, Kathy Nixon
目的癫痫严重程度全球评估 (GASE) 量表是一个单项、7 点的全球评级量表，专为神经科医师报告儿童癫痫的总体严重程度而设计。基于之前研究和临床使用有效性和可靠性的初步证据，本研究评估了 GASE 量表的构建有效性、可靠性以及对癫痫严重程度变化的反应性。 方法 用于研究的数据来自癫痫儿童健康相关生活质量研究 (HERQULES)，这是一项为期 2 年的多中心前瞻性队列研究 (n = 374)，在基线以及诊断后 6、12 和 24 个月进行观察。使用 Spearman 相关性和组内相关系数 (ICC) 对结构有效性和可靠性进行量化。使用基于分布和基于锚定的指数评估反应性。 结果 GASE 量表与几个关键临床方面至少中度相关（r 0.30），与癫痫发作的频率和强度以及癫痫或药物对日常活动的干扰最强相关（r > 0.30）。由癫痫的七个核心临床方面解释的 GASE 量表评分的总变异随着时间的推移而增加（基线时的 R-2 = 28% 到 24 个月时的 R-2 = 70%）。 GASE量表具有适度的重测可靠性（ICC范围：0.52-0.64），并且对临床标准的变化有反应（标准化反应平均范围：0.49-0.68；变化概率范围：0.69-0.75；Guyatt的反应性统计范围：0.56-0.84）。 GASE 量表显示出根据选择标准和综合评分（接受者操作特征 [ROC] 曲线范围下的面积：0.50-0.67）区分稳定和变化患者的潜力。显着性结果提供了额外的证据支持 GASE 量表的有效性、可靠性以及对儿童癫痫严重程度变化的反应性。我们的结论是，GASE 量表是评估临床和研究环境中癫痫严重程度的潜在有用工具。
ObjectiveThe Global Assessment of Severity of Epilepsy (GASE) Scale is a single-item, 7-point global rating scale designed for neurologist-report of overall severity of epilepsy in children. Building on previous preliminary evidence of its validity and reliability for research and clinical use, this study evaluated the GASE Scale's construct validity, reliability, and responsiveness to changes in severity of epilepsy.MethodsData used for the study arose from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a 2-year multicenter prospective cohort study (n = 374) with observations taken at baseline, and 6, 12, and 24 months after diagnosis. Construct validity and reliability were quantified using Spearman's correlation and intraclass correlation coefficient (ICC). Responsiveness was assessed using both distribution-based and anchor-based indices.ResultsThe GASE Scale was at least moderately correlated (r 0.30) with several key clinical aspects and most strongly correlated with frequency and intensity of seizures and interference of epilepsy or drugs with daily activities (r > 0.30). Total variation in GASE Scale scores explained by seven core clinical aspects of epilepsy increased over time (R-2 = 28% at baseline to R-2 = 70% at 24 months). The GASE Scale had modest test-retest reliability (ICC range: 0.52-0.64) and was responsive to changes in clinical criteria (standardized response mean range: 0.49-0.68; probability of change range: 0.69-0.75; Guyatt's responsiveness statistic range: 0.56-0.84). The GASE Scale showed potential to discriminate stable and changed patients according to select criteria and to a composite score (area under the receiver operating characteristic [ROC] curve range: 0.50-0.67).SignificanceResults offer additional evidence in support of the GASE Scale's validity, reliability, as well as responsiveness to changes in severity of epilepsy in children. We conclude that the GASE Scale is a potentially useful tool for assessing the severity of epilepsy in both clinical and research settings.