Validation of a Standardized Diagnostic Interview for Epilepsy

癫痫标准化诊断访谈的验证

• 批准号: 7921366
• 负责人: RUTH OTTMAN
• 金额: $ 7.97万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7921366
• 关键词: Address; Age; Agreement; Area; Classification; Clinical; Collection; Communities; Computer Assisted; Consent; Data; Diagnosis; Diagnostic; Electroencephalography; Epidemiologic Studies; Epidemiology; Epilepsy; Etiology; Failure; Focal Seizure; Gold; Incidence; International; Interview; Interviewer; Investigation; Medical Records; Mental disorders; Minnesota; Neurologic Examination; Online Systems; Patients; Principal Investigator; Recording of previous events; Research; Residencies; Resources; Savings; Seizures; Symptoms; Syndrome; System; Telephone; Telephone Interviews; Time; Training; Validation; Validity and Reliability; base; clinical Diagnosis; computerized; genetic epidemiology; improved; instrument; nervous system disorder; neuroimaging; population based; public health relevance; tool; validation studies

DESCRIPTION (provided by principal investigator): Standardized tools for clinical diagnosis and classification are essential for consistency in epidemiologic studies, and are especially important for epilepsy because diagnosis and classification are largely based on patient history. Despite the importance of this problem, however, few tools have been developed for standardized collection of clinical information in the epilepsies. In the late 1980's we created a telephone-administered semistructured Epilepsy Diagnostic Interview for clinical classification. The original instrument had good inter-rater reliability and validity for distinguishing between generalized and partial seizures. However, since these early validation studies, we have made major revisions to the instrument to refine our ability to characterize seizure symptoms and thereby improve classification. In the current study we propose to validate this revised instrument and make it available to the research community in a web-based computerized telephone interview format. The data for validation will be from a population-based investigation using Rochester Epidemiology Project resources, the Genetic Epidemiology of Seizure Disorders in Rochester (GESDR) study. GESDR included all Rochester residents born in 1920 or later with incidence of unprovoked seizures from 1935-1994. For each of these subjects, two expert epileptologists carried out a comprehensive review of all medical record information from onset of seizures to last residency in the Rochester area (including seizure descriptions, EEG, neuroimaging, treatment history, etc.) and rendered a final epilepsy diagnosis and classification based on current ILAE criteria. Independently of the medical record review, we administered our current diagnostic interview to each surviving subject who consented, and the same epileptologists reviewed the interview data and rendered a diagnosis and classification based on interview data alone. In the validation study we will assess agreement between these two diagnoses, using the medical record diagnosis as the gold standard. PUBLIC HEALTH RELEVANCE: This project will evaluate the accuracy of clinical classification of epilepsy based on information collected in a standardized telephone interview. It will also produce a web-based computer-assisted telephone interview version of the validated interview. This should facilitate the conduct of epidemiologic research on the causes and consequences of epilepsy at a significant savings of time and money.

描述（由主要研究者提供）：用于临床诊断和分类的标准化工具对于流行病学研究的一致性至关重要，对于癫痫尤其重要，因为诊断和分类主要基于患者的病史。尽管这个问题很重要，然而，很少有工具被开发用于标准化收集癫痫的临床信息。在20世纪80年代后期，我们创建了一种电话管理的半结构化癫痫诊断访谈，用于临床分类。原始仪器在区分全身性和部分性癫痫发作方面具有良好的信度和效度。然而，由于这些早期的验证研究，我们对仪器进行了重大修改，以完善我们表征癫痫症状的能力，从而改进分类。在目前的研究中，我们建议验证这一修订后的工具，并将其以基于网络的计算机电话访谈形式提供给研究界。用于验证的数据将来自基于人群的调查，使用罗切斯特流行病学项目资源，罗切斯特癫痫发作疾病遗传流行病学（GESDR）研究。GESDR包括所有出生于1920年或之后的罗切斯特居民，1935-1994年期间无诱发性癫痫的发生率。对于每一位受试者，两名癫痫专家对从癫痫发作到罗切斯特地区最后一次住院的所有医疗记录信息（包括癫痫发作描述、脑电图、神经成像、治疗史等）进行了全面的回顾，并根据当前的ILAE标准给出了最终的癫痫诊断和分类。独立于病历审查之外，我们对每位同意的存活受试者进行了当前的诊断性访谈，相同的癫痫学家回顾了访谈数据，并仅根据访谈数据进行诊断和分类。在验证研究中，我们将评估这两种诊断之间的一致性，使用病历诊断作为金标准。