Evidence map›Paper›PMID 37969060›Full record

ArticleEpilepsia open2024

Efficacy and safety of a smartphone application-based treatment of ketogenic diet in pediatric refractory epilepsy.

Wei Li, Wei Gu, Chao Liang, Fulai Tu, Le Ding, Xiaopeng Lu, Hu Guo, Guo Zheng, Chunfeng Wu

Open access · goldAbstract read
In one paragraph

Article in Epilepsia open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. 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

9 authors at 3 institutions in 3 countries.

Wei LiDepartment of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China.ORCID 0000-0003-0769-5805
Wei GuDepartment of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China.
Chao LiangDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Fulai TuKey Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
Le DingDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Xiaopeng LuDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Hu GuoDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Guo ZhengDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Chunfeng WuDepartment of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Second Affiliated Hospital of Nanjing Medical University · CNZero to Three · USSoutheast University · BD

Funding

Jiangsu Commission of Health ZD2022053The Clinical Research project of Children's Hospital of Nanjing Medical University LCYJY202306
6 · The paper itself

Abstract

objectiveWe aimed to find predictors for smartphone application-based ketogenic diet (KD) treatment effectiveness and safety.

methodsThe efficacy was evaluated according to the reduction in seizure frequency after the intervention of KD; safety was evaluated based on adverse effects. The ordinal logistic regression analysis was used to explore the influencing factors of efficacy.

resultsThe study sample included 116 males and 65 females with a median age of 2.27 years. The baseline frequency of seizure was more than five times/day in 123 children, 50.83% of them received three or more antiepileptic drugs (AEDs). Seventy-two patients' KD initiation mode was outpatient, and 73 completed the 12-month follow-up. A total of 88 (48.62%) patients had reported a reduction in seizure ≥50%. Compared with 12 months, those who had received KD therapy for only 3 (P = 0.009) and 6 months (P = 0.005) were more likely to show negative outcomes. Outpatient initiation had better outcomes (P = 0.029) than inpatient initiation. For the number of AEDs applied, patients on two AEDs were more likely to achieve better outcomes (P = 0.001). Adverse events had been noted among 77 patients; BMI Z-score at KD initiation was associated with adverse effects (P = 0.003). SIGNIFICANCE: Our study suggested that outpatient initiation and long-term treatment of KD should be encouraged. PLAIN LANGUAGE SUMMARY: Our research shows that the KD is a helpful treatment for children with refractory epilepsy, reducing seizures by more than 50% in nearly half of the cases, with some experiencing complete seizure freedom. We used a smartphone app to improve communication between patients and their healthcare teams, resulting in a high retention, and app usage was linked to reduced adverse effects. We recommend early consideration of KD treatment for patients failing two AED, encourage outpatient initiation, and advocate for longer-term KD use.

Indexed as

Diet, KetogenicDrug Resistant EpilepsyMobile ApplicationsAnticonvulsantsChildChild, PreschoolFemaleHumansMaleRetrospective StudiesSeizuresSmartphoneAnticonvulsantsefficacyketogenic dietpediatricrefractory epilepsysafety

Identifiers

PMID37969060
PMCPMC10839295
OpenAlexW4388733283

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.