Usage of EpiFinder clinical decision support in the assessment of epilepsy

Erin M. Okazaki, Robert Yao, Joseph I. Sirven, Amy Z. Crepeau, Katherine H. Noe, Joseph F. Drazkowski, Matthew T. Hoerth, Edgar Salinas, Lidia Csernak, Neel Mehta

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The diagnosis of epilepsy is at times elusive for both neurologists and nonneurologists, resulting in delays in diagnosis and therapy. The development of screening methods has been identified as a priority in response to this diagnostic and therapeutic gap. EpiFinder is a novel clinical decision support tool designed to enhance the process of information gathering and integration of patient/proxy respondent data. It is designed specifically to take key terms from a patient's history and incorporate them into a heuristic algorithm that dynamically produces differential diagnoses of epilepsy syndromes. Objective: The objective of this study was to test the usability and diagnostic accuracy of the clinical decision support application EpiFinder in an adult population. Methods: Fifty-seven patients were prospectively identified upon admission to the Epilepsy Monitoring Unit (EMU) for episode classification from January through June of 2017. Based on semiologic input, the application generates a list of epilepsy syndromes. The EpiFinder-generated diagnosis for each subject was compared to the final diagnosis obtained via continuous video electroencephalogram (cVEEG) monitoring. Results: Fifty-three patients had habitual events recorded during their EMU stay. A diagnosis of epilepsy was confirmed (with cVEEG monitoring) in 26 patients while 27 patients were found to have a diagnosis other than epilepsy. The algorithm appropriately predicted differentiation between the presence of an epilepsy syndrome and an alternative diagnosis with 86.8% (46/53 participants) accuracy. EpiFinder correctly identified the presence of epilepsy with a sensitivity of 86.4% (95% confidence interval [CI]: 65.0–97.1) and specificity of 85.1% (95% CI: 70.2–96.4). Conclusion: The initial testing of the EpiFinder algorithm suggests possible utility in differentiating between an epilepsy syndrome and an alternative diagnosis in adult patients.

Original languageEnglish (US)
Pages (from-to)140-143
Number of pages4
JournalEpilepsy and Behavior
Volume82
DOIs
StatePublished - May 1 2018

Fingerprint

Clinical Decision Support Systems
Epilepsy
Electroencephalography
Confidence Intervals
Proxy
Routine Diagnostic Tests
Differential Diagnosis

Keywords

  • Clinical decision support tool
  • Epilepsy diagnostic gap
  • Epilepsy monitoring unit
  • Mobile application

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Okazaki, E. M., Yao, R., Sirven, J. I., Crepeau, A. Z., Noe, K. H., Drazkowski, J. F., ... Mehta, N. (2018). Usage of EpiFinder clinical decision support in the assessment of epilepsy. Epilepsy and Behavior, 82, 140-143. https://doi.org/10.1016/j.yebeh.2018.03.018

Usage of EpiFinder clinical decision support in the assessment of epilepsy. / Okazaki, Erin M.; Yao, Robert; Sirven, Joseph I.; Crepeau, Amy Z.; Noe, Katherine H.; Drazkowski, Joseph F.; Hoerth, Matthew T.; Salinas, Edgar; Csernak, Lidia; Mehta, Neel.

In: Epilepsy and Behavior, Vol. 82, 01.05.2018, p. 140-143.

Research output: Contribution to journalArticle

Okazaki, EM, Yao, R, Sirven, JI, Crepeau, AZ, Noe, KH, Drazkowski, JF, Hoerth, MT, Salinas, E, Csernak, L & Mehta, N 2018, 'Usage of EpiFinder clinical decision support in the assessment of epilepsy', Epilepsy and Behavior, vol. 82, pp. 140-143. https://doi.org/10.1016/j.yebeh.2018.03.018
Okazaki EM, Yao R, Sirven JI, Crepeau AZ, Noe KH, Drazkowski JF et al. Usage of EpiFinder clinical decision support in the assessment of epilepsy. Epilepsy and Behavior. 2018 May 1;82:140-143. https://doi.org/10.1016/j.yebeh.2018.03.018
Okazaki, Erin M. ; Yao, Robert ; Sirven, Joseph I. ; Crepeau, Amy Z. ; Noe, Katherine H. ; Drazkowski, Joseph F. ; Hoerth, Matthew T. ; Salinas, Edgar ; Csernak, Lidia ; Mehta, Neel. / Usage of EpiFinder clinical decision support in the assessment of epilepsy. In: Epilepsy and Behavior. 2018 ; Vol. 82. pp. 140-143.
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abstract = "Background: The diagnosis of epilepsy is at times elusive for both neurologists and nonneurologists, resulting in delays in diagnosis and therapy. The development of screening methods has been identified as a priority in response to this diagnostic and therapeutic gap. EpiFinder is a novel clinical decision support tool designed to enhance the process of information gathering and integration of patient/proxy respondent data. It is designed specifically to take key terms from a patient's history and incorporate them into a heuristic algorithm that dynamically produces differential diagnoses of epilepsy syndromes. Objective: The objective of this study was to test the usability and diagnostic accuracy of the clinical decision support application EpiFinder in an adult population. Methods: Fifty-seven patients were prospectively identified upon admission to the Epilepsy Monitoring Unit (EMU) for episode classification from January through June of 2017. Based on semiologic input, the application generates a list of epilepsy syndromes. The EpiFinder-generated diagnosis for each subject was compared to the final diagnosis obtained via continuous video electroencephalogram (cVEEG) monitoring. Results: Fifty-three patients had habitual events recorded during their EMU stay. A diagnosis of epilepsy was confirmed (with cVEEG monitoring) in 26 patients while 27 patients were found to have a diagnosis other than epilepsy. The algorithm appropriately predicted differentiation between the presence of an epilepsy syndrome and an alternative diagnosis with 86.8{\%} (46/53 participants) accuracy. EpiFinder correctly identified the presence of epilepsy with a sensitivity of 86.4{\%} (95{\%} confidence interval [CI]: 65.0–97.1) and specificity of 85.1{\%} (95{\%} CI: 70.2–96.4). Conclusion: The initial testing of the EpiFinder algorithm suggests possible utility in differentiating between an epilepsy syndrome and an alternative diagnosis in adult patients.",
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