Evidence map›Paper›PMID 33197798›Full record

ArticleEpilepsy & behavior : E&B2020

Objective score from initial interview identifies patients with probable dissociative seizures.

Wesley T Kerr, Emily A Janio, Andrea M Chau, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Norma L Gallardo, Corinne H Allas, Amir H Karimi and 18 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior : E&B, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 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

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Unmet needs in functional neurological disorder related to digital healthcare.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2026
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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

28 authors.

Wesley T KerrDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA; Department of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA. Electronic address: WesleyTK@g.UCLA.edu.
Emily A JanioDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Andrea M ChauDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Chelsea T BraeschDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Justine M LeDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Jessica M HoriDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Akash B PatelDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Norma L GallardoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Corinne H AllasDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Amir H KarimiDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Ishita DubeyDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Siddhika S SreenivasanDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Janar BauirjanDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Eric S HwangDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Emily C DavisDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Shannon R D'AmbrosioDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Mona Al BannaDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
Rajarshi MazumderDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Ting WuDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Zachary A DeCantDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Michael G GibbsDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Edward ChangDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Xingruo ZhangDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Andrew Y ChoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
Nicholas J BeimerDepartment of Neurology, University of Michigan, Ann Arbor, MI, USA.
Jerome EngelDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Brain Research Institute, University of California Los Angeles, Los Angeles, California, USA.
Mark S CohenDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California Los Angeles, Los Angeles, California, USA; Departments of Radiology, Psychology, Biomedical Physics, and Bioengineering, University of California, Los Angeles, Los Angeles, CA, USA; California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA, USA.
John M SternDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Funding

UCLA-Caltech Medical Scientist Training ProgramT32GM008042 · NIGMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI AJIJOLA, OLUJIMI A, DAWSON, DAVID WAYNE · 1985 to 2023
$29.9M
YALE CENTER FOR THE: LEARNING &ATTENTIONP41RR013642 · NCRR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SMALL, GARY WILLIAM · 1998 to 2011
$21.9M
Systems in Integrative BiologyT32GM008185 · NIGMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CHOU, TOM · 1987 to 2022
$4.6M
Translational Neuroscience Training GrantR25NS065723 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CARMICHAEL, STANLEY THOMAS · 2009 to 2023
$2.8M
Comprehensive Training in Neuroimaging Fundamentals and ApplicationsR90DA023422 · NIDA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI COHEN, MARK STEVEN · 2006 to 2015
$1.7M
The Epilepsy Bioinformatics Study (EpiBioS)P20NS080181 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ENGEL, JEROME NONE, HOVDA, DAVID A · 2012 to 2014
$1.7M
Comprehensive Training in Neuroimaging Fundamentals and ApplicationsT90DA022768 · NIDA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI COHEN, MARK STEVEN · 2006 to 2015
$1.5M
UCLA Neuroscience Physician-Scientist Training ProgramUE5NS065723 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Stanley Thomas Carmichael, Jason D Hinman · 2024 to 2026
$1.2M
NCRR NIH HHS P41 RR013642NIDA NIH HHS R90 DA023422NIDA NIH HHS T90 DA022768NIGMS NIH HHS T32 GM008042NIGMS NIH HHS T32 GM008185NINDS NIH HHS P20 NS080181NINDS NIH HHS R25 NS065723NINDS NIH HHS UE5 NS065723
6 · The paper itself

Abstract

objectiveTo develop a Dissociative Seizures Likelihood Score (DSLS), which is a comprehensive, evidence-based tool using information available during the first outpatient visit to identify patients with "probable" dissociative seizures (DS) to allow early triage to more extensive diagnostic assessment.

methodsBased on data from 1616 patients with video-electroencephalography (vEEG) confirmed diagnoses, we compared the clinical history from a single neurology interview of patients in five mutually exclusive groups: epileptic seizures (ES), DS, physiologic nonepileptic seizure-like events (PSLE), mixed DS plus ES, and inconclusive monitoring. We used data-driven methods to determine the diagnostic utility of 76 features from retrospective chart review and applied this model to prospective interviews.

resultsThe DSLS using recursive feature elimination (RFE) correctly identified 77% (95% confidence interval (CI), 74-80%) of prospective patients with either ES or DS, with a sensitivity of 74% and specificity of 84%. This accuracy was not significantly inferior than neurologists' impression (84%, 95% CI: 80-88%) and the kappa between neurologists' and the DSLS was 21% (95% CI: 1-41%). Only 3% of patients with DS were missed by both the fellows and our score (95% CI 0-11%). SIGNIFICANCE: The evidence-based DSLS establishes one method to reliably identify some patients with probable DS using clinical history. The DSLS supports and does not replace clinical decision making. While not all patients with DS can be identified by clinical history alone, these methods combined with clinical judgement could be used to identify patients who warrant further diagnostic assessment at a comprehensive epilepsy center.

Indexed as

Conversion DisorderSeizuresDissociative DisordersElectroencephalographyHumansProspective StudiesRetrospective StudiesArtificial intelligenceClinical decision support toolFunctional seizuresMachine learningPsychogenic nonepileptic seizures

Identifiers

PMID33197798
PMCPMC7736162

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