Vickrey B G, Hays R D, Engel J, Spritzer K, Rogers W H, Rausch R, Graber J, Brook R H
Department of Neurology, University of California, Los Angeles 90024-1769.
Ann Neurol. 1995 Feb;37(2):158-66. doi: 10.1002/ana.410370205.
Epilepsy surgery is an increasingly common treatment for intractable epilepsy; yet there is no clear consensus among experts on how to report epilepsy surgery outcome. Most published outcome reporting systems focus on seizure frequency and type but differ in how they define clinically distinct outcome categories. We used a reliable and valid measure of self-reported health-related quality of life (HRQOL), the Epilepsy Surgery Inventory (ESI)-55, as an external standard by which to evaluate seven previously published, seizure-based outcome classification systems. The ESI-55 was administered to 133 adults who had previously undergone surgery for intractable epilepsy, and results were linked to data on their seizure occurrence before and after surgery (over the year prior to their HRQOL reports). These 133 patients were classified according to each seizure-based outcome system, and variation in HRQOL across outcome groups was evaluated using analysis of variance. Results reveal noteworthy variation in the extent to which different systems reflect patients' HRQOL at follow-up. We modified existing systems to derive a seizure-based surgery outcome system that most closely reflects HRQOL when applied over the latest 1-year postoperative interval.
癫痫手术是治疗难治性癫痫越来越常用的方法；然而，专家们对于如何报告癫痫手术结果尚无明确的共识。大多数已发表的结果报告系统侧重于发作频率和类型，但在如何定义临床上不同的结果类别方面存在差异。我们使用了一种可靠且有效的自我报告的健康相关生活质量（HRQOL）测量方法，即癫痫手术量表（ESI）-55，作为外部标准来评估之前发表的七个基于发作的结果分类系统。ESI-55被应用于133名曾接受过难治性癫痫手术的成年人，结果与他们手术前后（在他们报告HRQOL的前一年）的发作数据相关联。这133名患者根据每个基于发作的结果系统进行分类，并使用方差分析评估不同结果组之间HRQOL的差异。结果显示，不同系统在反映随访时患者HRQOL的程度上存在显著差异。我们对现有系统进行了修改，以得出一个基于发作的手术结果系统，该系统在应用于最新的术后1年间隔时最能反映HRQOL。
