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Predicting seizure freedom with AED treatment in newly diagnosed patients with MRI-negative epilepsy: A large cohort and multicenter study
- Source :
- Epilepsybehavior : EB. 106
- Publication Year :
- 2020
-
Abstract
- Objective We developed and validated a prediction score for predicting the probability of 6-month and 12-month seizure freedom of antiepileptic drug (AED) treatment in newly diagnosed patients with magnetic resonance imaging (MRI)-negative epilepsy. Methods The development cohort included 543 consecutive patients from the Epilepsy Center of Henan Provincial People's Hospital, while the validation cohorts included 493 consecutive patients in two independent cohorts. Univariate analysis and a forward and backward elimination of multivariate Cox regression analysis were used to select predictive factors. The performance of the score was evaluated with C-index, calibration plots, and decision curve analysis. The risk stratification was also performed. Results The score included five routinely available predictors including Circadian rhythms, Electroencephalography before AED treatment, Neuropsychiatric disorders, Perinatal brain injury, and History of central nervous system infection (CENPH score). When applied to the external validation cohort, the score showed good discrimination with C-index (development group: 0.83; validation group: 0.78), and calibration plots indicated well calibration, as well as the decision curve analysis showed good predictive accuracy and clinical values in four cohorts. The points of the score were categorized to the following three probability levels for predicting seizure freedom: high probability (0–83.11 points), medium probability (83.11–122.71 points), and low probability (> 122.71 points). And online calculator was established to make this score easily applicable in clinical practice. Conclusions We established a simple, practical, and evidence-based prediction score for predicting seizure freedom with AEDs to aid in the clinical consultation and treatment decision for the newly diagnosed patients with MRI-negative epilepsy.
- Subjects :
- Adult
Male
Multivariate statistics
Pediatrics
medicine.medical_specialty
Adolescent
Electroencephalography
Cohort Studies
03 medical and health sciences
Behavioral Neuroscience
Epilepsy
Young Adult
0302 clinical medicine
Predictive Value of Tests
Pregnancy
Seizures
medicine
Humans
030212 general & internal medicine
Retrospective Studies
Univariate analysis
medicine.diagnostic_test
Proportional hazards model
business.industry
Magnetic resonance imaging
Seizure freedom
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Treatment Outcome
Neurology
Cohort
Anticonvulsants
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15255069
- Volume :
- 106
- Database :
- OpenAIRE
- Journal :
- Epilepsybehavior : EB
- Accession number :
- edsair.doi.dedup.....b17ab7a50579fe562539fa4114989b7f