IWK Health Centre and Dalhousie University.
Epilepsy Behav. 2013 Nov;29(2):305-7. doi: 10.1016/j.yebeh.2013.08.003. Epub 2013 Sep 12.
The internet has become the first stop for the public and patients to seek health-related information. Video-sharing websites are particularly important sources of information for those seeking answers about seizures and epilepsy. Because of the widespread popularity of YouTube, we sought to explore whether a seizure diagnosis and classification could reliably be applied. All videos related to "seizures" were reviewed, and irrelevant videos were excluded. The remaining 162 nonduplicate videos were analyzed by 4 independent pediatric neurologists who classified the events as epilepsy seizures, nonepileptic seizures, or indeterminate. Videos designated as epilepsy seizures were then classified into focal, generalized, or unclassified. At least 3 of the 4 reviewers agreed that 35% of the videos showed that the events were "epilepsy seizures", at least 3 of the 4 reviewers agreed that 28% of the videos demonstrated that the events were "nonepileptic seizures", and there was good agreement that 7% of the videos showed that the event was "indeterminate". Overall, interrater agreement was moderate at k=0.57 for epilepsy seizures and k=0.43 for nonepileptic seizures. For seizure classification, reviewer agreement was greatest for "generalized seizures" (k=0.45) and intermediate for "focal seizures" (k=0.27), and there was no agreement for unclassified events (k=0.026, p=0.2). Overall, neurology reviewer agreement suggests that only approximately one-third of the videos designated as "seizures" on the most popular video-sharing website, YouTube, definitely depict a seizure. Caution should be exercised in the use of such online video media for accessing educational or self-diagnosis aids for seizures.
互联网已成为公众和患者获取健康相关信息的首选途径。视频分享网站对于那些正在寻找癫痫发作相关答案的人来说，是特别重要的信息来源。由于 YouTube 的广泛普及，我们试图探索是否可以可靠地应用癫痫发作的诊断和分类。我们对所有与“癫痫发作”相关的视频进行了审查，并排除了不相关的视频。然后，由 4 位独立的儿科神经病学家对其余 162 个非重复视频进行分析，将这些事件分类为癫痫发作、非癫痫发作或不确定。将被指定为癫痫发作的视频进一步分为局灶性、全面性或无法分类。至少有 3 位评审员一致认为，35%的视频显示的事件为“癫痫发作”，至少有 3 位评审员一致认为，28%的视频显示的事件为“非癫痫发作”，有 7%的视频显示事件为“不确定”。总体而言，对于癫痫发作，评审员之间的一致性为中度（κ=0.57），对于非癫痫发作，一致性为 0.43。对于癫痫发作分类，评审员的一致性最高为“全面性发作”（κ=0.45），其次是“局灶性发作”（κ=0.27），而对于无法分类的事件，一致性为 0.026（p=0.2）。总体而言，神经科评审员的一致意见表明，在最受欢迎的视频分享网站 YouTube 上，被指定为“癫痫发作”的视频中，只有大约三分之一肯定描绘了癫痫发作。在使用此类在线视频媒体获取癫痫发作的教育或自我诊断辅助工具时，应谨慎行事。
