J 2024

Grading system for assessing the confidence in the epileptogenic zone reported in published studies: A Delphi consensus study

RYVLIN, Philippe, Carmen BARBA, Fabrice BARTOLOMEI, Christoph BAUMGARTNER, Milan BRÁZDIL et. al.

Základní údaje

Originální název

Grading system for assessing the confidence in the epileptogenic zone reported in published studies: A Delphi consensus study

Autoři

RYVLIN, Philippe, Carmen BARBA, Fabrice BARTOLOMEI, Christoph BAUMGARTNER, Milan BRÁZDIL (203 Česká republika, domácí), Daniel FABO, Firas FAHOUM, Birgit FRAUSCHER, Akio IKEDA, Samden LHATOO, Jayanti MANI, Aileen MCGONIGAL, Eeva-Liisa METSAHONKALA, Ioana MINDRUTA, Dang Khoa NGUYEN, Sylvain RHEIMS, Rodrigo ROCAMORA, Bertil RYDENHAG, Stephan SCHUELE, Andreas SCHULZE-BONHAGE, Rainer SURGES, Serge VULLIEMOZ a Sandor BENICZKY

Vydání

Epilepsia, Hoboken, WILEY-BLACKWELL, 2024, 0013-9580

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30210 Clinical neurology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 5.600 v roce 2022

Organizační jednotka

Lékařská fakulta

UT WoS

001175356900001

Klíčová slova anglicky

confidence; Delphi; epilepsy surgery; epileptogenic zone; grading system

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 12. 7. 2024 13:17, Mgr. Tereza Miškechová

Anotace

V originále

ObjectiveThis 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.MethodsWe 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.ResultsThe 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.SignificanceThe 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.