A validation of the new definition of drug‐resistant epilepsy by the International League Against Epilepsy

Summary Objective To establish applicability, the recently proposed International League Against Epilepsy (ILAE) consensus on drug‐resistant epilepsy (DRE) requires testing in clinical and research settings. This study evaluates the reliability and validity of these criteria in a clinical population...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2014-06, Vol.55 (6), p.829-834
Main Authors: Téllez‐Zenteno, Jose F., Hernández‐Ronquillo, Lizbeth, Buckley, Samantha, Zahagun, Ricardo, Rizvi, Syed
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anticonvulsants - therapeutic use
Consensus
Drug Resistance
Drug‐resistant epilepsy
Epilepsy
Epilepsy - diagnosis
Epilepsy - drug therapy
Female
Humans
Male
Middle Aged
Observer Variation
Prevalence
Reliability
Reproducibility of Results
Validation
Validity
Young Adult
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Summary:Summary Objective To establish applicability, the recently proposed International League Against Epilepsy (ILAE) consensus on drug‐resistant epilepsy (DRE) requires testing in clinical and research settings. This study evaluates the reliability and validity of these criteria in a clinical population. Methods In phase I, two independent evaluators reviewed 97 randomly selected medical records of patients with epilepsy at two separate intervals. Both ILEA consensus and standard diagnostic criteria were employed. Kappa, weighted kappa, and intraclass correlation coefficient (ICC) were used to determine interobserver and intraobserver variability. In phase II, ILAE consensus criteria were applied to 250 patients with epilepsy to determine risk factors associated with development of DRE and to calculate point prevalence. Results The interobserver agreement of the four definitions was as follows: Berg (0.56), Kwan and Brodie (0.58), Camfield and Camfield (0.69), and ILAE (0.77). The intraobserver agreement of the four definition was as follows: Berg (0.81), Kwan and Brodie (0.82), Camfield and Camfield (0.72), and ILAE (0.82). The prevalence of DRE was the following: with the Berg's definition was 28.4%, Kwan and Brodie 34%, Camfield and Camfield 37%, and with ILAE was 33%. Significance This is first study to establish reliability and validity of ILAE criteria for the diagnosis of DRE. This new definition compares favorably with previously established constructs, which continue to retain clinical significance.
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.12633