A Community-Based Screening Tool for Childhood Epilepsy: Cross-Cultural Adaptation and Validation of the INDT-EPI Tool in Punjabi-Speaking Indian Population.

BACKGROUND AND OBJECTIVES

Early diagnosis of epilepsy is crucial for improving outcomes. However, access to specialized healthcare remains a challenge in many regions. This study aimed to adapt and validate the International Clinical Epidemiology Network Diagnostic Tool for Epilepsy (INDT-EPI) for screening childhood epilepsy in the Punjabi-speaking Indian population.

METHODS

A cross-sectional study was conducted among parents of children aged 1-18 years. The INDT-EPI tool was translated into Punjabi, back-translated, and pilot-tested. Psychometric properties, including internal consistency, were assessed using Cronbach's alpha. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) and Pearson correlation. Split-half reliability was evaluated using Spearman-Brown prophecy correlation coefficients. Sensitivity and specificity were calculated by comparing the findings of the INDT-EPI tool with clinical diagnoses.

RESULTS

The Punjabi version of the INDT-EPI tool demonstrated excellent cross-language concordance and robust psychometric properties. The tool's internal consistency, as measured by Cronbach's alpha, ranged from 0.904 to 1.000, indicating strong consistency across items. Test-retest reliability, assessed using ICC, ranged from 0.88 to 1.00, signifying excellent reliability. The Punjabi version of the INDT-EPI tool exhibited a high sensitivity of 86.6% (95% confidence interval [CI]: 79.2%-93.9%) and specificity of 87.1% (95% CI: 75.3%-98.9%). These findings suggest that the tool is a reliable and effective screening instrument for identifying children with epilepsy in Punjabi-speaking communities.

CONCLUSIONS

The Punjabi version of the INDT-EPI tool is a reliable and consistent instrument for diagnosing epilepsy in children. Its excellent psychometric properties make it suitable for non-specialist healthcare providers. By enabling early diagnosis, it can improve patient outcomes and address the need for effective epilepsy diagnosis where specialized resources are scarce.