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Grading system for assessing the confidence in the epileptogenic zone reported in published studies: A Delphi consensus study
P. Ryvlin, C. Barba, F. Bartolomei, C. Baumgartner, M. Brazdil, D. Fabo, F. Fahoum, B. Frauscher, A. Ikeda, S. Lhatoo, J. Mani, A. McGonigal, EL. Metsahonkala, I. Mindruta, DK. Nguyen, S. Rheims, R. Rocamora, B. Rydenhag, S. Schuele, A....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
38420750
DOI
10.1111/epi.17928
Knihovny.cz E-zdroje
- MeSH
- delfská metoda * MeSH
- elektroencefalografie * MeSH
- epilepsie * chirurgie diagnostické zobrazování diagnóza MeSH
- konsensus * MeSH
- lidé MeSH
- magnetická rezonanční tomografie * normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: This study was undertaken to develop a standardized grading system based on expert consensus for evaluating the level of confidence in the localization of the epileptogenic zone (EZ) as reported in published studies, to harmonize and facilitate systematic reviews in the field of epilepsy surgery. METHODS: We conducted a Delphi study involving 22 experts from 18 countries, who were asked to rate their level of confidence in the localization of the EZ for various theoretical clinical scenarios, using different scales. Information provided in these scenarios included one or several of the following data: magnetic resonance imaging (MRI) findings, invasive electroencephalography summary, and postoperative seizure outcome. RESULTS: The first explorative phase showed an overall interrater agreement of .347, pointing to large heterogeneity among experts' assessments, with only 17% of the 42 proposed scenarios associated with a substantial level of agreement. A majority showed preferences for the simpler scale and single-item scenarios. The successive Delphi voting phases resulted in a majority consensus across experts, with more than two thirds of respondents agreeing on the rating of each of the tested single-item scenarios. High or very high levels of confidence were ascribed to patients with either an Engel class I or class IA postoperative seizure outcome, a well-delineated EZ according to all available invasive EEG (iEEG) data, or a well-delineated focal epileptogenic lesion on MRI. MRI signs of hippocampal sclerosis or atrophy were associated with a moderate level of confidence, whereas a low level was ascribed to other MRI findings, a poorly delineated EZ according to iEEG data, or an Engel class II-IV postoperative seizure outcome. SIGNIFICANCE: The proposed grading system, based on an expert consensus, provides a simple framework to rate the level of confidence in the EZ reported in published studies in a structured and harmonized way, offering an opportunity to facilitate and increase the quality of systematic reviews and guidelines in the field of epilepsy surgery.
APHM Timone Hospital Epileptology and Cerebral Rhythmology Marseille France
Brno Epilepsy Center Department of Neurology St Anne's University Hospital Brno Czech Republic
Department of Clinical Medicine Aarhus University Aarhus Denmark
Department of Epileptology University Hospital Bonn Bonn Germany
Department of Neurology and Biomedical Engineering Duke University Durham North Carolina USA
Department of Neurology Northwestern University Chicago Illinois USA
Department of Neurology Tel Aviv Sourasky Medical Center
Department of Neurology University of Texas Health Science Center Houston Texas USA
Department of Neurosurgery Sahlgrenska University Hospital Gothenburg Sweden
Division of Neurology Centre Hospitalier de l'Université de Montréal Montreal Quebec Canada
Emergency University Hospital Bucharest Bucharest Romania
Epilepsia Helsinki Helsinki University Hospital Helsinki Finland
Epilepsy Center Neurocenter University Medical Center University of Freiburg Freiburg Germany
Faculty of Health and Life Sciences Universitat Pompeu Fabra Barcelona Spain
Faculty of Medicine Tel Aviv University Tel Aviv Israel
Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology Vienna Austria
Kokilaben Dhirubhai Ambani Hospital and Medical Research Center Mumbai India
Neuroscience Department Meyer Children's Hospital IRCCS Florence Italy
Citace poskytuje Crossref.org
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