Validation of a Standardized Diagnostic Interview for Epilepsy

描述(由首席研究人员提供)：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，对癫痫尤其重要，因为诊断和分类在很大程度上是基于患者的病史。然而，尽管这个问题很重要，但很少有工具被开发用于标准化收集癫痫的临床信息。上世纪80年代末，S创建了电话管理的半结构式癫痫诊断访谈，用于临床分型。原始量表在区分全身性发作和部分性发作方面具有良好的评定者间信度和效度。然而，自从这些早期的验证研究以来，我们对该工具进行了重大修改，以完善我们表征癫痫症状的能力，从而改善分类。在目前的研究中，我们建议验证这一经修订的工具，并以基于网络的计算机化电话访谈的形式向研究界提供。用于验证的数据将来自使用罗切斯特流行病学项目资源的基于人群的调查，即罗切斯特癫痫疾病遗传流行病学(GESDR)研究。GESDR包括1920年或以后出生的所有罗切斯特居民，在1935-1994年间有无故癫痫发作的发生率。对于每个受试者，两名癫痫专家对从癫痫发作开始到最后在罗切斯特地区居住的所有医疗记录信息进行了全面审查(包括癫痫描述、脑电、神经成像、治疗史等)。并根据目前的ILAE标准进行了最终的癫痫诊断和分类。除了病历审查，我们对每个同意的幸存受试者进行了目前的诊断性访谈，相同的癫痫专家审查了访谈数据，并仅根据访谈数据进行了诊断和分类。在验证研究中，我们将使用病历诊断作为金标准来评估这两种诊断之间的一致性。 公共卫生相关性：该项目将根据在标准化电话访谈中收集的信息来评估癫痫临床分类的准确性。它还将制作经确认的面谈的网络计算机辅助电话面谈版本。这应有助于对癫痫的原因和后果进行流行病学研究，大大节省时间和金钱。

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.