A Nomogram to Predict Seizure Outcomes after Resective Epilepsy Surgery

项目总结： 目前正在考虑接受癫痫手术的患者接受了关于他/她的预期机会的咨询 基于大型手术队列中普通总体成功率的癫痫发作自由。回答……问题 “像我这样的病人”在手术后的表现基本上取决于医生对复合体的理解。 术前检测：事实上，没有客观的、可重复的、有效的方法来全面地 将术前检查的结果合并到个性化的结果预测中。这种不确定性 推迟对可能受益于癫痫手术的患者进行手术检查，并可能导致 对实际上可能不是很好的外科候选人的其他人进行多余、有风险和徒劳的测试。这是一个多方面的 将项目建立在已开发的统计模型基础上，从基础数据中添加信息 任何手术前评估的组成部分，包括脑电、脑成像和临床特征，以 开发一种名为“癫痫手术图”(ESN)的增强在线工具，允许定制结果 预测。使用ESN，治疗患者癫痫的医生将能够更好地评估 癫痫手术后的癫痫发作自由，并将拥有一种工具，通过提供 个性化、定制化的咨询。目标是通过以下方式改善对癫痫患者的护理：1)- 更早地确定手术候选对象，以及2)-确定复杂的病例，需要专门的全面 癫痫中心效率更高。

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.