title: Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in a series of 76 patients.
abstract: The inter-rater reliability, expressed as kappa score, k, of the Engel and International League Against Epilepsy (ILAE) classifications of epilepsy surgery seizure outcome has not previously been evaluated. In a consecutive series of 76 patients (40 male; 25 children), 75 undergoing resective and 1 disconnective surgery at a mean age of 27.5 years (13 months-62 years), one observer classified 88% (n=67) and a second observer classified 87% (n=66) of patients as either Engel I or II (free from or rare disabling seizures) after a median follow up of 36 months (range 12-92 months); comparably, both observers classified 84% (n=64) as ILAE 1-3. Correlation for Engel versus ILAE for observer 1 was 0.933 (p<.0005) and for observer 2 was 0.931 (p<.0005). Both ILAE (k 0.81, 95% confidence intervals 0.69, 0.91) and Engel (k 0.77, 95% CI 0.65, 0.87) classifications have very acceptable inter-rater reliability as well as significant correlation.
authors.affiliation: Paediatric Neurology, Southampton University Hospitals NHS Trust, Southampton, UK. Andrew.Durnford@suht.swest.nhs.uk
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Durnford
authors.forename: William
authors.initials: W
authors.lastname: Rodgers
authors.forename: Fenella J
authors.initials: FJ
authors.lastname: Kirkham
authors.forename: Mark A
authors.initials: MA
authors.lastname: Mullee
authors.forename: Andrea
authors.initials: A
authors.lastname: Whitney
authors.forename: Martin
authors.initials: M
authors.lastname: Prevett
authors.forename: Lucy
authors.initials: L
authors.lastname: Kinton
authors.forename: Matthew
authors.initials: M
authors.lastname: Harris
authors.forename: William P
authors.initials: WP
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D015588:Observer Variation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult