Journal article
Diagnostic accuracy of paroxysmal spells: Clinical history versus observation
Epilepsy & behavior, Vol.78, pp.73-77
01/01/2018
DOI: 10.1016/j.yebeh.2017.09.001
PMID: 29175694
Abstract
Our goal was to evaluate how accurate neurologists are at differentiating between different paroxysmal events based on clinical history versus observation of the spell in question. Forty-seven neurologists reviewed 12 clinical histories and videos of recorded events of patients admitted in the Epilepsy Monitoring Unit (EMU). They were asked to diagnose events as epileptic seizures, non-epileptic behavioral spells (NEBS), or other physiologic events as well as rate their confidence in their diagnosis. Themedian diagnostic accuracy for all paroxysmal events was 67% for clinical history and 75% for observation (p=.001). This was largely due to the difference in accuracy within the subgroup of patients with NEBS (67% history vs. 83% observation, p < .001). There were trends for higher diagnostic accuracy and increased inter-rater agreement with higher levels of training. Physicians with higher levels of training weremore confident with diagnosis based on observation. In summary, reviewing videos of paroxysmal spells may improve diagnostic accuracy and enhance the evaluation of patients. Neurologists at all levels of training should encourage the recording and review of videos of recurrent spells to aid in medical decision-making especially when there is high concern that the spells in question are NEBS. (C) 2017 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Diagnostic accuracy of paroxysmal spells: Clinical history versus observation
- Creators
- Brian Hanrahan - University of Pittsburgh Medical CenterGena Ghearing - Roy J. and Lucille A. Carver College of MedicineAlexandra Urban - University of Pittsburgh Medical CenterCheryl Plummer - University of Pittsburgh Medical CenterJulie Pan - University of Pittsburgh Medical CenterRick Hendrickson - University of Pittsburgh Medical CenterAnto Bagic - University of Pittsburgh Medical CenterArun Antony - University of Pittsburgh Medical Center
- Resource Type
- Journal article
- Publication Details
- Epilepsy & behavior, Vol.78, pp.73-77
- Publisher
- Elsevier
- DOI
- 10.1016/j.yebeh.2017.09.001
- PMID
- 29175694
- ISSN
- 1525-5050
- eISSN
- 1525-5069
- Number of pages
- 5
- Grant note
- UL1TR001857 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1-TR-001857 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 01/01/2018
- Academic Unit
- Neurology
- Record Identifier
- 9984303027802771
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