Evidence map›Paper›PMID 30900756›Full record

ArticleEpilepsia2019

Identifying patients who will not reachieve remission after breakthrough seizures.

David M Hughes, Laura J Bonnett, Anthony G Marson, Marta García-Fiñana

Abstract read
In one paragraph

Article in Epilepsia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

David M HughesDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Laura J BonnettDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Anthony G MarsonDepartment of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Marta García-FiñanaDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.

Funding

Department of Health PDF-2015-08-044Department of Health RP-PG-0606-1062Engineering and Physical Sciences Research Council EP/N014499/1Medical Research Council UK MR/L010909/1Medical Research Council UK MR/R024847/1National Institute for Health Research NIHR CLAHRC NWC
6 · The paper itself

Abstract

objectiveWe aim to identify people with epilepsy who are unlikely to reachieve a 12-month remission within 2 years after experiencing a breakthrough seizure following an initial 12-month remission.

methodsWe apply a novel longitudinal discriminant approach to data from the Standard and New Antiepileptic Drugs study to dynamically predict the risk of a patient not achieving a second remission after a breakthrough seizure by combining both baseline covariates (collected at the time of breakthrough seizure) and follow-up data.

resultsThe model classifies 83% of patients. Of these, 73% of patients (95% confidence interval [CI] = 58%-88%) who did not achieve a second remission were correctly identified (sensitivity), and 84% of patients (95% CI = 69%-96%) who achieved a second remission were correctly identified (specificity). The area under the curve from our model was 87% (95% CI = 80%-94%). Patients who did not achieve a second remission were correctly identified on average after 10 months of observation postbreakthrough. Occurrence of seizures after breakthrough and the number of seizures experienced were the most informative longitudinal variables. These longitudinal profiles were influenced by the following baseline covariates: age at breakthrough seizure, presence of neurological insult, and number of antiepileptic drugs required to achieve first remission. SIGNIFICANCE: Using longitudinal data gathered during patient follow-up allows more accurate predictions than using baseline covariates in a standard Cox model. The model developed in this paper is a useful first step in developing a tool for identifying patients who develop drug resistance after an initial remission.

Indexed as

Models, StatisticalTreatment FailureAdultAnticonvulsantsFemaleHumansMaleRandomized Controlled Trials as TopicRecurrenceRemission InductionSeizuresAnticonvulsantsbreakthroughdynamic classificationepilepsyfocalgeneralizedremission

Identifiers

PMID30900756
PMCPMC6487810

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.