title: A Novel Parent Questionnaire for the Detection of Seizures in Children.
abstract: BACKGROUND
  We developed a seizure questionnaire that could be administered by a trained research assistant in a two-step process, approximating the clinical diagnostic process of a pediatric epileptologist. This questionnaire was designed to study seizure prevalence in a research population of 10-year-old children at risk for epilepsy.
  
  
  METHODS
  English-speaking parents of children 6 months to 12 years old were recruited from the pediatric neurology clinics at Boston Medical Center and interviewed using a computerized questionnaire. An algorithm of parent responses rendered a 4-level ranking scale of seizure probability for events: (1) not likely, (2) indeterminate, (3) probable, (4) almost certain. Blinded to questionnaire results, pediatric neurologists served as the diagnostic gold standard, ranking each patient event using the same four-level scale based on clinical history and examination.
  
  
  RESULTS
  The questionnaire was completed by 150 of 177 (84.7%) enrolled parents. Seizure prevalence among participants was 38.6%. The seizure questionnaire yielded a fitted receiver operating characteristic area of 0.93 (95% confidence interval [CI], 0.89-0.97). Based on optimal sensitivity and false-positive fraction, we dichotomized the questionnaire results as consistent with seizure (levels 3 and 4) or without seizure (levels 1 and 2). Overall, findings included a 91.4% sensitivity (95% CI, 84.2%-98.6%) and an 82.6% specificity (95% CI, 74.9%-90.4%). The positive predictive value was 76.8% (95% CI, 66.9%-86.8%) and the negative predictive value was 93.8% (95% CI, 88.6%-99.1%).
  
  
  CONCLUSIONS
  This pediatric seizure questionnaire was both sensitive and specific for detecting clinically confirmed seizures. This tool may be useful to researchers and clinicians in screening large populations of children, decreasing the time and cost of added neurological assessments.
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts. Electronic address: laurie.douglass@bmc.org.
authors.forename: Laurie M
authors.initials: LM
authors.lastname: Douglass
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Karl
authors.initials: K
authors.lastname: Kuban
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tarquinio
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts.
authors.forename: Leah
authors.initials: L
authors.lastname: Schraga
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Rinat
authors.initials: R
authors.lastname: Jonas
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: William A
authors.initials: WA
authors.lastname: DeBassio
authors.affiliation: Division of Pediatric Neurology, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Carl E
authors.initials: CE
authors.lastname: Stafstrom
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Ryan John
authors.initials: RJ
authors.lastname: Heinrick
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts.
authors.forename: Chantal
authors.initials: C
authors.lastname: Ferguson
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts.
authors.forename: Lauren
authors.initials: L
authors.lastname: Blumberg
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Wong
mesh_terms: D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003201:Computers; D020000:Decision Support Systems, Clinical; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004569:Electroencephalography; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D015995:Prevalence; D012372:ROC Curve; D012306:Risk; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
keywords: children; epilepsy; parent; pediatric; questionnaire; seizure; survey; validation studies