Abstract:
People with epilepsy frequently under- or inaccurately report their seizures, which poses a challenge for evaluating their treatment. The introduction of epilepsy health apps provides a novel approach that could improve seizure documentation. This study assessed the documentation performance of an app-based seizure diary and a conventional paper seizure diary. At two tertiary epilepsy centers patients were asked to use one of two offered methods to report their seizures (paper or app diary) during their stay in the epilepsy monitoring unit. The performances of both methods were assessed based on the gold standard of video-EEG annotations. In total 89 adults (54 paper and 35 app users) with focal epilepsy were included in the analysis, of which 58 (33 paper and 25 app users) experienced at least one seizure and made at least one seizure diary entry. We observed a high precision of 85.7% for the app group, whereas the paper group\'s precision was lower due to overreporting (66.9%). Sensitivity was similar for both methods. Our findings imply that performance of seizure self-reporting is patient-dependent but is more precise for patients who are willing to use digital apps. This may be relevant for treatment decisions and future clinical trial design.
摘要:
癫痫患者经常低于或不准确地报告他们的癫痫发作,这对评估他们的治疗提出了挑战。癫痫健康应用程序的引入提供了一种新颖的方法,可以改善癫痫发作记录。这项研究评估了基于应用程序的癫痫发作日记和常规纸质癫痫发作日记的文档性能。在两个三级癫痫中心,患者被要求在癫痫监测单元逗留期间使用两种提供的方法之一报告癫痫发作(纸质或应用程序日记)。两种方法的性能均基于视频EEG注释的黄金标准进行评估。共有89名成年人(54名纸质和35名应用程序用户)患有局灶性癫痫,其中58名(33名纸质用户和25名应用程序用户)经历了至少一次癫痫发作,并进行了至少一次癫痫发作日记。我们观察到应用程序组的85.7%的高精度,而论文组的精度较低,由于多报(66.9%)。两种方法的灵敏度相似。我们的发现表明,癫痫自我报告的表现取决于患者,但对于愿意使用数字应用程序的患者来说更为精确。这可能与治疗决策和未来的临床试验设计有关。