Cowan L D, Leviton A, Bodensteiner J B, Doherty L
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Paediatr Perinat Epidemiol. 1989 Oct;3(4):386-401. doi: 10.1111/j.1365-3016.1989.tb00527.x.
A prevalence study of childhood epilepsy in central Oklahoma allowed a comparison of different sources of case-finding. The percentage of all epilepsy cases identified was lowest (9%) from physicians' office records. Higher rates were obtained from review of emergency room records (40%), hospital inpatient records (45%), electroencephalography (EEG) requisitions (68%) and outpatient clinic records (62%). Nearly one-third of the 1159 epilepsy cases were identified from only one source. EEG requisitions provided most of these cases. Although the percentage of all abstracts from one source that identified cases was lowest for EEG requisitions (43%), these abstracts were prepared with much less effort and time than were abstracts from hospital or clinic records, which had higher levels of efficiency (hospital = 52%, clinic = 73%). Hospital inpatient records identified a disproportionate number of children with newborn seizures, simple partial epilepsy, and partial seizures secondarily generalised, and children with multiple developmental handicaps. Fully 10% of all cases had an episode of status epilepticus and, as might be expected, emergency room and hospital inpatient records preferentially identified them. We conclude that case-finding for epidemiological studies of epilepsy in children in some communities is best done through review of EEG requisitions, supplemented by information from outpatient records.
一项针对俄克拉荷马州中部儿童癫痫的患病率研究，对不同病例发现来源进行了比较。从医生办公室记录中识别出的所有癫痫病例百分比最低（9%）。通过审查急诊室记录（40%）、医院住院记录（45%）、脑电图（EEG）申请单（68%）和门诊记录（62%）获得了更高的比例。在1159例癫痫病例中，近三分之一仅从一个来源被识别出来。EEG申请单提供了这些病例中的大部分。虽然从一个来源识别病例的所有摘要中，EEG申请单的比例最低（43%），但与医院或诊所记录的摘要相比，这些摘要的编写工作量和时间要少得多，而医院或诊所记录的效率更高（医院 = 52%，诊所 = 73%）。医院住院记录识别出的新生儿惊厥、简单部分性癫痫和继发性全身性部分性癫痫患儿以及患有多种发育障碍的患儿数量不成比例。所有病例中有整整10%发生过癫痫持续状态，正如预期的那样，急诊室和医院住院记录优先识别出这些病例。我们得出结论，在某些社区，儿童癫痫流行病学研究的病例发现最好通过审查EEG申请单来完成，并辅以门诊记录中的信息。
