Validation of a Standardized Diagnostic Interview for Epilepsy

描述（由主要研究者提供）：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，对于癫痫尤其重要，因为诊断和分类主要基于患者病史。尽管这个问题的重要性，但是，很少有工具已经开发的癫痫临床信息的标准化收集。在20世纪80年代后期，我们创建了一个电话管理的半结构化癫痫诊断访谈的临床分类。原始工具有良好的评分者间的信度和效度区分全面和部分性发作。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订，以改进我们表征癫痫症状的能力，从而改善分类。在目前的研究中，我们建议验证这一修订后的文书，并使其提供给研究界在基于网络的计算机化的电话采访格式。验证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，即罗切斯特癫痫发作疾病遗传流行病学（GESDR）研究。GESDR包括1935-1994年期间出生于1920年或更晚的所有罗切斯特居民，这些居民发生了无端癫痫发作。对于这些受试者中的每一个，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病历信息进行了全面审查（包括癫痫发作描述、EEG、神经成像、治疗史等）。并根据现行ILAE标准进行最终癫痫诊断和分类。独立于病历审查，我们对每位同意的幸存受试者进行了当前的诊断访谈，相同的癫痫学家审查了访谈数据，并仅根据访谈数据进行了诊断和分类。在验证研究中，我们将评估这两种诊断之间的一致性，使用医疗记录诊断作为金标准。 公共卫生相关性：本项目将根据标准化电话访谈收集的信息评估癫痫临床分类的准确性。它还将制作经验证的面谈的网上计算机辅助电话面谈版本。这将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.