The use of computer-assisted-telephone-interviewing to diagnose seizures, epilepsy and idiopathic generalized epilepsy.
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 (kappa)], 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 (kappa=0.94), seizure-onset types (kappa=0.84), simple or complex partial seizures (kappa=0.87), any generalized non-convulsive seizure (kappa=0.82), and IGE (kappa=0.82). Although substantial, agreement was not as close for secondarily generalized seizures (kappa=0.74), and generalized tonic-clonic seizures (kappa=0.79). This related more to under-recognition of individual generalized non-convulsive seizures rather than misinterpretation of partial seizures.


CONCLUSIONS
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.
D'Souza
Wendyl J
WJ
The Menzies Research Institute, The University of Tasmania, Hobart, Tasmania, Australia. wendyl@unimelb.edu.au
Stankovich
Jim
J
O'Brien
Terence J
TJ
Bower
Simon
S
Pearce
Neil
N
Cook
Mark J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted / Q000592:standards / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis; D004829:Epilepsy, Generalized / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards; D015203:Reproducibility of Results; D012640:Seizures / Q000145:classification / Q000175:diagnosis*; D055815:Young Adult