Evidence map›Paper›PMID 31182508›Full record

SynthesisNeurology2019

Epilepsy duration and seizure outcome in epilepsy surgery: A systematic review and meta-analysis.

Johan Bjellvi, Ingrid Olsson, Kristina Malmgren, Karin Wilbe Ramsay

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 6 pooled it
–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

54 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Early surgical approaches in pediatric epilepsy - a systematic review and meta-analysis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023
    Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Seminars in epileptology: Presurgical epilepsy evaluation.Epileptic disorders : international epilepsy journal with videotape · 2025
    Review
  19. Article
  20. Article
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.

Johan BjellviFrom the Institute of Neuroscience and Physiology, Department of Clinical Neuroscience (J.B., K.M.), and Institute of Clinical Sciences, Department of Paediatrics (I.O.), Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg; and Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) (K.W.R.), Stockholm, Sweden. johan.bjellvi@vgregion.se.ORCID 0000-0001-5275-5489
Ingrid OlssonFrom the Institute of Neuroscience and Physiology, Department of Clinical Neuroscience (J.B., K.M.), and Institute of Clinical Sciences, Department of Paediatrics (I.O.), Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg; and Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) (K.W.R.), Stockholm, Sweden.
Kristina MalmgrenFrom the Institute of Neuroscience and Physiology, Department of Clinical Neuroscience (J.B., K.M.), and Institute of Clinical Sciences, Department of Paediatrics (I.O.), Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg; and Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) (K.W.R.), Stockholm, Sweden.
Karin Wilbe RamsayFrom the Institute of Neuroscience and Physiology, Department of Clinical Neuroscience (J.B., K.M.), and Institute of Clinical Sciences, Department of Paediatrics (I.O.), Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg; and Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) (K.W.R.), Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo conduct a systematic review and meta-analysis on the effect of earlier or later resective epilepsy surgery on seizure outcome.

methodsWe searched the electronic databases PubMed, EMBASE, and Cochrane Library for studies investigating the association of epilepsy duration and seizure freedom after resective surgery. Two reviewers independently screened citations for eligibility and assessed relevant studies for risk of bias. We combined data in meta-analyses using a random effects model. We assessed the certainty of evidence according to Grading of Recommendations Assessment, Development and Evaluation (GRADE).

resultsTwenty-five studies were included, 12 of which had data suitable for meta-analyses. Comparing seizure outcome if epilepsy surgery was performed before vs after 2, 5, 10, and 20 years of epilepsy duration, and comparing epilepsy duration <5 years to >10 years, we found significant effects favoring shorter duration with risk differences ranging from 0.15 to 0.21 and risk ratios ranging from 1.20 to 1.33 (

conclusionPeople with shorter epilepsy duration are more likely to be seizure-free at follow-up. Furthermore, there is a positive association between shorter duration and seizure freedom also for very long epilepsy durations. Patients who might benefit from epilepsy surgery should therefore be referred for presurgical assessments without further delay, regardless of epilepsy duration. The low certainty of evidence acknowledges concerns regarding study heterogeneity and possible residual confounding.

Indexed as

Drug Resistant EpilepsyHumansReferral and ConsultationTime FactorsTime-to-TreatmentTreatment Outcome

Identifiers

PMID31182508
PMCPMC6656653

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.