Validation of a brief screening instrument for the ascertainment of epilepsy.
Validation of a brief screening instrument for the ascertainment of epilepsy.
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DOI：
10.1111/j.1528-1167.2009.02274.x
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发表时间：
2010-02
期刊：
影响因子：
5.6
通讯作者：
Buchhalter JR
中科院分区：
文献类型：
--
作者：
Ottman R;Barker-Cummings C;Leibson CL;Vasoli VM;Hauser WA;Buchhalter JR
验证流行病学或遗传学研究中用于识别癫痫患者的简单筛查工具。我们设计了一个9个问题的癫痫筛查工具，并通过电话对有病历记录的癫痫患者（一生中有≥2次无端癫痫发作史，n = 168）或孤立的无端癫痫发作患者（n = 54）以及在病历审查中无癫痫发作的患者（n = 120）进行了筛查，这些患者来自一项使用罗切斯特流行病学项目资源的基于人群的研究。访谈者对记录审查结果不知情。敏感性（受影响个体中筛选阳性的个体比例）为癫痫96%，孤立性无端癫痫发作87%。假阳性率（FPR，在无结核病个体中筛查阳性的比例）为7%。癫痫的估计阳性预测值（PPV）为23%，假设人群的终生患病率为2%。仅使用一个问题询问受试者是否曾患有癫痫或癫痫发作疾病，敏感性为76%，FPR为0.8%，估计PPV为66%。如果癫痫患者在1964年后被诊断或在诊断后癫痫发作持续至少5年，则他们更有可能在这个问题上筛查出阳性。鉴于其高灵敏度，我们的仪器可能对癫痫筛查的第一阶段有用;然而，23%的PPV表明，只有大约四分之一的筛查阳性个体会真正受到影响。用一个关于癫痫的问题进行筛查，PPV较高，但敏感性较低，筛查阳性的受试者可能偏向于更严重的癫痫。
To validate a brief screening instrument for identifying people with epilepsy in epidemiologic or genetic studies. We designed a nine-question screening instrument for epilepsy and administered it by telephone to individuals with medical record–documented epilepsy (lifetime history of ≥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. 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. 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.
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影响因子：
2.2
作者：
Kelvin, Elizabeth A.;Hesdorffer, Dale C.;Hauser, W. Allen.
通讯作者：
Hauser, W. Allen.
影响因子：
7.2
作者：
MENEGHINI, F;ROCCA, WA;DIPERRI, R
通讯作者：
DIPERRI, R
影响因子：
5.7
作者：
OSUNTOKUN B O;SCHOENBERG B S;ET AL
通讯作者：
ET AL
影响因子：
9.9
作者：
OTTMAN, R;LEE, JH;SCHEUER, ML
通讯作者：
SCHEUER, ML
影响因子：
5.6
作者：
HAUSER, WA;ANNEGERS, JF;KURLAND, LT
通讯作者：
KURLAND, LT