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. 2015 Dec 31;5(2):84-8.
doi: 10.14581/jer.15014. eCollection 2015 Dec.

Clinical Prediction Rule of Drug Resistant Epilepsy in Children

Free PMC article

Clinical Prediction Rule of Drug Resistant Epilepsy in Children

Pairoj Boonluksiri et al. J Epilepsy Res. .
Free PMC article


Background and purpose: Clinical prediction rules (CPR) are clinical decision-making tools containing variables such as history, physical examination, diagnostic tests by developing scoring model from potential risk factors. This study is to establish clinical prediction scoring of drug-resistant epilepsy (DRE) in children using clinical manifestationa and only basic electroencephalography (EEG).

Methods: Retrospective cohort study was conducted. A total of 308 children with diagnosed epilepsy were recruited. Primary outcome was the incidence of DRE. Independent determinants were patient characteristics, clinical manifestations and electroencephalography. CPR was performed based on multiple logistic regression.

Results: The incidence of DRE was 42%. Risk factors were age onset, prior neurological deficits, and abnormal EEG. CPR can be established and stratified the prediction using scores into 3 levels such as low risk (score<6), moderate risk (score 6-12) and high risk (score>12) with positive likelihood ratio of 0.5, 1.8 and 12.5 respectively.

Conclusions: CPR with scoring risks were stratified into 3 levels. The strongest risk is prior global neurological deficits.

Keywords: Clinical prediction rule; Drug-resistant epilepsy; Risk factors.


Figure 1.
Figure 1.
Study flow. EEG, electroencephalography.
Figure 2.
Figure 2.
Stratification of risk score weighted by age onset into 3 groups. LR, likelihood ratio; CI, confidence interval.
Figure 3.
Figure 3.
Accuracy of DRE prediction by scoring explained by AUROC curve (0.764) and score distribution between DSE (0) and DRE (1). DRE, drug-resistant epilepsy; AUROC, area under the curve of receiver-operating characteristic; DSE, drug-responsive epilepsy.

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