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Multicenter Study
. 2019 Dec;6(12):2601-2606.
doi: 10.1002/acn3.50950. Epub 2019 Dec 5.

Investigation of patient and observer agreement on description of seizures at initial clinical visit

Maha N Saleem  1 , Christopher A Arencibia  1 , Kevin McKenna  2 , Sabrina Cristofaro  3 , Kamil Detyniecki  1 , Daniel Friedman  3 , Jacqueline French  3 , Hal Blumenfeld  1   4   5 ; HEP Investigators
Affiliations
Multicenter Study

Investigation of patient and observer agreement on description of seizures at initial clinical visit

Maha N Saleem et al. Ann Clin Transl Neurol. 2019 Dec.

Abstract

There have been few studies of agreement between seizure descriptions obtained from patients and observers. We investigated 220 patients and observers who completed structured questionnaires about patients' semiological seizure features at the initial clinical visit. Inter-rater reliability was assessed using Cohen's kappa and indices of positive and negative agreement. Patients and observers had excellent agreement on the presence of memory impairment and generalized shaking and stiffness during seizures. In addition, patients under-reported seizure descriptions more easily observed externally, whereas observers under-reported change in patient location at seizure end. These findings may guide interpretation of clinical histories obtain in epilepsy care.

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Conflict of interest statement

Maha Neha Saleem, Christopher Andrew Arencibia, Kevin McKenna, Sabrina Cristofaro, and Hal Blumenfeld report no disclosures. Dr. Kamil Detyniecki has received research support to Yale University for investigator‐initiated studies from Eisai, Sunovion, Acorda, and Upsher‐Smith. Dr. Daniel Friedman receives salary support for consulting and clinical trial related activities performed on behalf of the Epilepsy Study Consortium, a nonprofit organization. Dr. Friedman receives no personal income for these activities. NYU receives a fixed amount from the Epilepsy Study Consortium toward Dr. Friedman’s salary. Within the past year, the Epilepsy Study Consortium received payments for research services performed by Dr. Friedman from: Adamas, Biogen, CuroNZ, Engage Pharmaceuticals, Pfizer, Takeda, and Zynerba. He has also served as a paid consultant for Penumbra. He has received honoraria from Neuropace, Inc for educational materials. He receives research support from UCB, Inc and Empatica. Dr. Jacqueline French receives NYU salary support from the Epilepsy Foundation and for consulting work on behalf of the Epilepsy Study Consortium for Eisai, Lundbeck, Pfizer, Sunovion, and UCB Inc., who also support HEP. Dr. French has also received research grants from Eisai, Lundbeck, Pfizer, Sunovion, and UCB Inc.

Figures

Figure 1
Figure 1
Observers report more abnormal behaviors during seizures than patients. Seizure features where percentage of “Yes” and “No” reports differed significantly between observers and patients (P < 0.05, binomial test, Table 1) are shown in descending order of percent “Yes” responses by observers. Observers reported “Yes” more often than patients for 11 of 12 of these seizure features.
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References

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