Ottman R, Lee J H, Hauser W A, Hong S, Hesdorffer D, Schupf N, Pedley T A, Scheuer M L
Neurology. 1993 Dec;43(12):2526-30. doi: 10.1212/wnl.43.12.2526.
Methods for standardized classification of epileptic seizures are important for both clinical practice and epidemiologic research. In this study, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria. We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the seizure history, we also interviewed a first-degree relative for 67% of subjects and obtained medical records for 59%. Three lay reviewers used all available information to classify seizures. To assess reliability, each reviewer classified a sample of subjects assigned to the others. In addition, an expert physician classified a sample of subjects assigned to two of the reviewers. Agreement was "moderate-substantial" for generalized-onset seizures, both for the comparisons between pairs of lay reviewers and for the neurologist versus lay reviewers. Agreement was "substantial-almost perfect" for partial-onset seizures, both for pairs of lay reviewers and for the neurologist versus lay reviewers. These results suggest that seizures can be reliably classified by lay reviewers, using operational criteria applied to symptoms ascertained in a semistructured telephone interview.
癫痫发作的标准化分类方法对于临床实践和流行病学研究都很重要。在本研究中，我们开发了一种使用半结构化电话访谈和操作性诊断标准进行标准化分类的策略。我们对从志愿组织确定的1957名成年癫痫患者进行了访谈。为了确认并扩展发作病史，我们还对67%的受试者的一级亲属进行了访谈，并获取了59%受试者的医疗记录。三名非专业评审员利用所有可用信息对发作进行分类。为评估可靠性，每位评审员对分配给其他评审员的受试者样本进行分类。此外，一名专家医生对分配给两名评审员的受试者样本进行分类。对于全面性发作，无论是在非专业评审员之间的比较，还是神经科医生与非专业评审员之间的比较，一致性为“中等-高度”。对于局灶性发作，无论是在非专业评审员之间的比较，还是神经科医生与非专业评审员之间的比较，一致性为“高度-几乎完美”。这些结果表明，非专业评审员可以通过将操作性标准应用于在半结构化电话访谈中确定的症状，对发作进行可靠分类。
