ArticleNeurology2019
Assessment and effect of a gap between new-onset epilepsy diagnosis and treatment in the US.
Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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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.
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.
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Who cites it
23 citing papers in PubMed.
- Knowledge and awareness of epilepsy management, etiologies, and comorbidities among pediatricians in Palestine.BMC pediatrics · 2026Article
- Initial Monotherapy and Further Anti-seizure Medication Regimens in Adult Patients with Epilepsy: A Population-Based, Longitudinal, Retrospective Analysis of German Prescription Data.Neurology and therapy · 2026Article
- National Strategies on Bridging Gaps and Health Equity in Epilepsy Care.Epilepsy currents · 2026Article
- AI language model applications for early diagnosis of childhood epilepsy based on unstructured first-visit patient narratives: A cohort study.Epileptic disorders : international epilepsy journal with videotape · 2025Article
- Transfer to Adult Care in Epilepsy: A Nationwide Population-Based Register Study.Neurology. Clinical practice · 2025Article
- Epileptic Patients with More Clinic Visits Are More Likely to Be Diagnosed with Dementia-A Population-Based Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2024Article
- Primary treatment gap among adults with epilepsy: A cross-sectional analysis.Epileptic disorders : international epilepsy journal with videotape · 2024Article
- Impact of Seizures While Driving Prior to Diagnosis in People With Focal Epilepsy: Motor Vehicle Accidents and Time to Diagnosis.Neurology · 2023Article
- Characterizing the treatment gap in the United States among adult patients with a new diagnosis of epilepsy.Epilepsia · 2023Article
- Editorial: Epidemiology of epilepsy and seizures.Frontiers in epidemiology · 2023Article
- Incidence of and predictors for antiseizure medication gaps in Medicare beneficiaries with epilepsy: a retrospective cohort study.BMC neurology · 2022Article
- Barriers to and Disparities in Access to Health Care Among Adults Aged ≥18 Years with Epilepsy - United States, 2015 and 2017.MMWR. Morbidity and mortality weekly report · 2022Article
- Ethical considerations in the surgical and neuromodulatory treatment of epilepsy.Epilepsy & behavior : E&B · 2022Review
- Adherence to Antiseizure vs Other Medications Among US Medicare Beneficiaries With and Without Epilepsy.Neurology · 2022Article
- The use of virtual tools in narrowing the impact of health disparities in neurology.Frontiers in pediatrics · 2022Article
- Treatment gaps in epilepsy.Frontiers in epidemiology · 2022Review
- Geographic Variation in the Use of Gabapentinoids and Opioids for Pain in a Commercially Insured Adult Population in the United States.Journal of pain research · 2022Article
- Diagnostic Delay in Epilepsy: the Scope of the Problem.Current neurology and neuroscience reports · 2021Review
- Delays and disparities in diagnosis for adults with epilepsy: Findings from U.S. Medicaid data.Epilepsy research · 2020Article
- Relationship between early follow-up and readmission within 30 and 90 days after ischemic stroke.Neurology · 2020Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the treatment gap between a new epilepsy diagnosis and antiepileptic drug (AED) initiation in the United States.
methodsRetrospective claims-based cohort study using Truven Health MarketScan databases (commercial and supplemental Medicare, calendar years 2010-2015; Medicaid, 2010-2014) and a validation study using PharMetrics Plus Database linked to LRx claims database (2009-2014). Persons met epilepsy diagnostic criteria, had an index date (first epilepsy diagnosis) with a preceding 2-year baseline (1 year for persons aged 1 to <2 years; none for persons <1 year), and continuous medical and pharmacy enrollment without epilepsy/seizure diagnosis or AED prescription during baseline. Outcomes included percentage of untreated persons (no AED prescription) up to 3 years' follow-up and comparative outcomes (incidence rate ratio: untreated persons/treated persons), including medical events and health care resource utilization.
resultsIn the primary study, 59,970 persons met selection (or inclusion) criteria; 36.7% of persons with newly diagnosed epilepsy remained untreated up to 3 years after diagnosis. In the validation study (N = 30,890), 31.8% of persons remained untreated up to 3 years after diagnosis. Lack of AED treatment was associated with an adjusted incidence rate ratio (95% confidence interval) of 1.2 (1.2-1.3) for medical events, 2.3 (2.2-2.3) for hospitalizations, and 2.8 (2.7-2.9) for emergency department visits.
conclusionsOne-third of newly diagnosed persons remain untreated up to 3 years after epilepsy diagnosis. The increased risk of medical events and health care utilization highlights the consequences of delayed treatment after epilepsy diagnosis, which might be preventable.
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