妊娠期癫痫治疗的差异：一项全球调查。
Differences in treatment of epilepsy in pregnancy: A worldwide survey.
作者信息
George Ilena C, Bartolini Luca, Ney John, Singhal Divya
机构信息
Corinne Goldsmith Dickinson Center for Multiple Sclerosis (ICG), Mount Sinai, New York, NY; Clinical Epilepsy Section (LB), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; Center for Healthcare Organization and Implementation Research (JN), Edith Nourse Rogers Memorial VA, Bedford, MA; and Department of Neurology (DS), University of Oklahoma.
出版信息
Neurol Clin Pract. 2019 Jun;9(3):201-207. doi: 10.1212/CPJ.0000000000000642.
BACKGROUND
How to safely treat pregnant women with epilepsy is a question for which there are guidelines, but variations in practice exist.
METHODS
To better characterize how clinicians address this difficult clinical question, we distributed an anonymous survey to neurology practitioners across subspecialties and different levels of training via the ® website. The survey was conducted from May 31 to December 3, 2017. We received responses from 642 participants representing 81 countries. We performed both descriptive and inferential analyses. For the inferential analysis, a multiple logistic regression model was used to analyze the effect of provider characteristics on the constructed binary outcome variables of interest.
RESULTS
The results of this survey demonstrate a wide range in the amount of folic acid recommended and the frequency of checking levels of anti-epileptic drugs. Choice of first-line agent varied by the economic development status of the respondent's country, suggesting that access to medications plays an important role in clinical decision making in many parts of the world.
CONCLUSION
This survey highlights several areas where further research would be helpful in guiding practice.
背景
如何安全治疗癫痫孕妇是一个有相关指南的问题，但实际操作存在差异。
方法
为了更好地描述临床医生如何处理这个棘手的临床问题，我们通过[具体网站名称]向各亚专业及不同培训水平的神经科从业者发放了一份匿名调查问卷。调查于2017年5月31日至12月3日进行。我们收到了来自代表81个国家的642名参与者的回复。我们进行了描述性和推断性分析。对于推断性分析，使用多元逻辑回归模型来分析提供者特征对所构建的感兴趣二元结果变量的影响。
结果
本次调查结果显示，所推荐的叶酸量以及抗癫痫药物水平检查频率差异很大。一线药物的选择因受访者国家的经济发展状况而异，这表明在世界许多地区，药物可及性在临床决策中起着重要作用。
结论
本次调查突出了几个领域，进一步的研究将有助于指导实践。
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