The use of computer-assisted-telephone-interviewing to diagnose seizures, epilepsy and Idiopathic Generalized Epilepsy

D'Souza, Wendyl J.; Stankovich, Jim; O’Brien, Terence J.; Bower, Simon; Pearce, Neil; Cook, Mark J.

doi:10.1016/j.eplepsyres.2010.06.003

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Volume 91, Issue 1 , Pages 20-27, September 2010

The use of computer-assisted-telephone-interviewing to diagnose seizures, epilepsy and Idiopathic Generalized Epilepsy

Wendyl J. D'Souza
- The Menzies Research Institute, The University of Tasmania, Hobart, Tasmania, Australia
- The Department of Medicine, The University of Melbourne, St. Vincent's Hospital Melbourne, Victoria, Australia
- Corresponding author at: The Department of Medicine, The University of Melbourne, St. Vincent's Hospital Melbourne, PO Box 2900 Fitzroy 3065, Victoria, Australia. Tel.: +61 3 9288 3341; fax: +61 3 92883350.
Jim Stankovich
- The Menzies Research Institute, The University of Tasmania, Hobart, Tasmania, Australia
- The Division of Bioinformatics, The Walter & Eliza Hall Institute of Medical Research, 1G Royal Parade, Victoria, Australia
Terence J. O’Brien
- The Department of Medicine, The University of Melbourne, The Royal Melbourne Hospital, Victoria, Australia
Simon Bower
- The Comprehensive Epilepsy Program, Monash Neurology, Monash Medical Centre, Clayton, Victoria, Australia
Neil Pearce
- Centre for Public Health Research, Massey University Wellington Campus, Wellington, New Zealand
Mark J. Cook
- The Department of Medicine, The University of Melbourne, St. Vincent's Hospital Melbourne, Victoria, Australia

Received 24 March 2010; received in revised form 31 May 2010; accepted 5 June 2010.

Summary

Background

Computer-assisted-telephone-interviewing (CATI), widely used in market research, could be a useful alternative for conducting diagnostic interviews in epilepsy epidemiology.

Methods

We administered a diagnostic seizure questionnaire by CATI, interpreting the responses with standardized classification guidelines, compared against an epilepsy specialist's assessment, for agreement [Kappa statistic (κ)], sensitivity, specificity, positive predictive value, negative predictive value and Youden's Index (YI).

Results

99 outpatients with 382 lifetime events participated: 22 generalized-onset epilepsy [16 Idiopathic Generalized Epilepsy (IGE)], 59 partial-onset epilepsy, 12 non-epileptic and 6 uncertain. We observed almost perfect agreement in diagnosing epilepsy (κ=0.94), seizure-onset types (κ=0.84), simple or complex partial seizures (κ=0.87), any generalized non-convulsive seizure (κ=0.82), and IGE (κ=0.82). Although substantial, agreement was not as close for secondarily generalized seizures (κ=0.74), and generalized tonic-clonic seizures (κ=0.79). This related more to under-recognition of individual generalized non-convulsive seizures rather than misinterpretation of partial seizures.

Discussion

Epilepsy diagnostic questionnaires administered by CATI and interpreted with standardized diagnostic guidelines can effectively classify epilepsy, most seizure types and IGE in outpatients with suspected seizures. Applying this diagnostic method in ‘field’ settings will allow firmer conclusions to be drawn on its wider epidemiological utility.

Keywords: Epilepsy, Epidemiology, Questionnaires, Diagnosis, Validation