A Nomogram to Predict Seizure Outcomes after Resective Epilepsy Surgery

预测癫痫切除手术后癫痫发作结果的列线图

• 批准号: 9308504
• 负责人: Lara Jehi
• 金额: $ 57.4万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9308504
• 关键词: Age; Anatomy; Applications Grants; Brain imaging; Caring; Characteristics; Classification; Clinic; Clinical; Complex; Convulsions; Counseling; Custom; Data; Decision Making; Development; Diagnostic; Diffusion Magnetic Resonance Imaging; Discrimination; Drug resistance; Electroencephalography; Epilepsy; Etiology; Evaluation; Excision; Family history of; Freedom; Frequencies; Functional Magnetic Resonance Imaging; Gene Targeting; Generic Drugs; Genetic; Goals; Gold; Handedness; Judgment; Lead; Lobe; Magnetic Resonance Imaging; Measurement; Measures; Methodology; Methods; Modeling; Multicenter Studies; Neurology; Nomograms; Operative Surgical Procedures; Outcome; Partial Epilepsies; Pathologic; Patient Care; Patients; Pattern; Performance; Physicians; Positron-Emission Tomography; Postoperative Period; Process; Prognostic Marker; Prospective cohort; Public Health; Publishing; Quantitative Evaluations; Recording of previous events; Recruitment Activity; Reproducibility; Resource Allocation; Rest; Retrospective cohort; Risk; Sampling; Seizures; Severity of illness; Site; Statistical Models; Supervision; Surgical Pathology; Testing; Time; Uncertainty; Universities; Validation; Work; base; cohort; gene panel; hazard; improved; individual patient; neuroimaging; outcome prediction; personalized medicine; predictive modeling; prognostic assays; prospective; sex; standard care; study population; success; tool; treatment choice; user-friendly

Project Summary: A patient currently considering epilepsy surgery receives counseling about his/her expected chances of seizure-freedom based on generic overall rates of success in large surgical cohorts. Answering the question of how “a patient like me” will do after surgery essentially depends on the physician's interpretation of complex pre-surgical testing: in fact, there is no objective, reproducible, and validated method to comprehensively combine the results of the pre-surgical work-up into an individualized outcome prediction. This uncertainty delays the initiation of surgical work-ups in patients who may benefit from epilepsy surgery, and may lead to redundant, risky, and futile testing in others who may actually not be good surgical candidates. This is a multi- center project building on an already developed statistical model, adding information from the fundamental components of any pre-surgical evaluation, including EEG, brain imaging, and clinical characteristics to develop an enhanced online tool called the “Epilepsy Surgery Nomogram” (ESN) allowing a tailored outcome prediction. Using the ESN, the physician treating a patient's epilepsy will be better able to assess the chances of seizure-freedom following epilepsy surgery, and will have a tool to assist decision-making by providing personalized and customized counseling. The goal will be to improve the care of patients with epilepsy by:1)- identifying surgical candidates earlier, and 2)- identifying complex cases needing a dedicated comprehensive epilepsy center more efficiently.

项目概要： 目前正在考虑癫痫手术的患者接受关于他/她预期的癫痫发作机会的咨询。 基于大型手术队列中通用总体成功率的无并发症。回答这个问题 “像我这样的病人”在手术后会怎么做，基本上取决于医生对复杂的 术前测试：事实上，没有客观、可重复和有效的方法来全面 联合收割机将术前检查的结果组合成个体化的结果预测。这种不确定性 延迟可能受益于癫痫手术的患者的手术开始，并可能导致 多余的，有风险的，徒劳的测试，在其他人谁可能实际上不是很好的手术候选人。这是一个多- 中心项目建立在一个已经开发的统计模型上， 任何术前评估的组成部分，包括EEG、脑成像和临床特征， 开发一种名为“癫痫手术列线图”（ESN）的增强型在线工具， 预测.使用ESN，治疗癫痫患者的医生将能够更好地评估 癫痫手术后的自由，并将有一个工具，以协助决策，提供 个性化和定制的咨询服务。目标是通过以下方式改善癫痫患者的护理：1）- 及早识别手术候选人，以及2）识别需要专门的全面 癫痫中心更有效。