Hartford HealthCare, 85 Seymour St, Hartford, CT 06102, United States; Norton Neuroscience Institute, 4915 Norton Healthcare Blvd, Louisville, KY 40241, United States.
Stanford University School of Medicine, 213 Quarry Rd, Palo Alto, CA 94304, United States.
Epilepsy Behav. 2022 May;130:108691. doi: 10.1016/j.yebeh.2022.108691. Epub 2022 Apr 19.
The Personal Impact of Epilepsy Scale (PIES) assesses patient functional status in subscales of (1) seizure impact, (2) medication effects, (3) mood & social status, and (4) overall quality of life. This study was designed to determine the Minimal Clinically Important Change (MCID) in PIES subscale and total scores that demonstrate improvement.
To ascertain the correspondence of PIES score change and clinical status change (improved, same, worse) in each PIES subscale and total score, we used two distinct retrospective anchor-based assessments of clinical status (patient self-assessment and trained rater assessment) across two clinic visits. Mean PIES scores were compared between clinical status groups, controlling for days between visits and initial clinical status. Personal Impact of Epilepsy Scale score change was quantified for each group to determine MCID. A small prospective proof-of-concept study was conducted in a separate subject group.
Patient self-report anchor analysis demonstrated lower (better) PIES scores in the "improved" group vs the "worse" group on the mood & social subscale (p < .001) and total score (p = .002), with a similar trend on the seizure subscale (p = 0.056). Clinical rater anchor analysis demonstrated lower PIES scores in the "improved" vs "worse" group in the mood & social subscale (p = .029) and a trend in total score (p = .082). For the "improved" group, the reduction in PIES scores between visits averaged across both anchor analyses was 8.14% for subscales and 8.67% for total score.
DISCUSSION/CONCLUSION: Reduction of 8% on a PIES subscale or total score indicates meaningful improvement in patient clinical status, and is designated the MCID for this instrument. Personal Impact of Epilepsy Scale can be useful in day-to-day clinical care and as an outcome metric in clinical research.
个人癫痫影响量表（PIES）评估了患者在（1）癫痫发作影响、（2）药物作用、（3）情绪和社会地位以及（4）整体生活质量等分方面的功能状态。本研究旨在确定 PIES 量表分和总分中显示改善的最小临床重要变化（MCID）。
为了确定 PIES 量表评分变化与临床状况变化（改善、相同、恶化）在每个 PIES 量表分和总分中的对应关系，我们使用了两次独立的基于回顾性的临床状态评估（患者自我评估和经过培训的评估者评估），跨越了两次就诊。在控制就诊天数和初始临床状态的情况下，比较了不同临床状态组之间的 PIES 平均得分。为了确定 MCID，对每个组的 PIES 评分变化进行量化。在一个单独的患者组中进行了一项小规模的前瞻性概念验证研究。
患者自我报告的锚定分析显示，在情绪和社会子量表（p <.001）和总分（p =.002）上，“改善”组的 PIES 评分较低（更好），而在“恶化”组中得分较高，在癫痫子量表上也呈现出类似的趋势（p =.056）。临床评估者的锚定分析显示，在情绪和社会子量表（p =.029）和总分上（p =.082），“改善”组的 PIES 评分较低。对于“改善”组，两次就诊之间的 PIES 评分变化在两种锚定分析中的平均值为子量表 8.14%，总分为 8.67%。
讨论/结论：PIES 子量表或总分降低 8%表明患者临床状态有显著改善，这是该工具的 MCID。PIES 可用于日常临床护理，并作为临床研究的结果指标。
