title: The current state of epilepsy guidelines: A systematic review.
abstract: OBJECTIVE
  The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development.
  
  
  METHODS
  A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. Two independent reviewers screened abstracts, reviewed full text articles, and performed data abstraction. Descriptive statistics and a meta-analysis were generated.
  
  
  RESULTS
  The search identified 10,926 abstracts. Of the 410 articles selected for full text review, 63 met our eligibility criteria for a guideline. Of those included, 54 were in English and 9 were in other languages (French, Spanish, and Italian). Of all guidelines, 29% did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus (n = 7), first seizure (n = 6), drug-resistant epilepsy (n = 5), and febrile seizures (n = 4), among others. Most of the guidelines were therapeutic (n = 35) or diagnostic (n = 16) in nature. The quality of the guidelines using a 1-7 point scale (7 = highest) varied and was moderate overall (mean = 4.99 ± 1.05 [SD]).
  
  
  CONCLUSIONS
  We identified substantial gaps in topics (e.g., epilepsy in the elderly) and there was considerable heterogeneity in methodologic quality. The findings should offer a valuable resource for health professionals caring for people with epilepsy, since they will help guide the prioritization, development, and dissemination of future epilepsy-related guidelines.
authors.affiliation: Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Khara M
authors.initials: KM
authors.lastname: Sauro
authors.affiliation: Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
authors.affiliation: Department of Paediatrics, Kings Mill Hospital, Sutton in Ashfield, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Dunkley
authors.affiliation: Department of Neurology, University of Pecs, Pecs, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Janszky
authors.affiliation: Department of Neurosciences, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Kumlien
authors.affiliation: Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience and Department of Pediatrics, Laboratory of Developmental Epilepsy, Montefiore/Einstein Epilepsy Management Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, U.S.A.
authors.forename: Solomon
authors.initials: S
authors.lastname: Moshé
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Tohoku, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Nakasato
authors.affiliation: Department of Neurology, Neurological Institute of New York, Columbia University Medical Center, New York, New York, U.S.A.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Pedley
authors.affiliation: Department of Internal Medicine & Therapeutics, Unit of Clinical and Experimental Pharmacology, University of Pavia and C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Perucca
authors.affiliation: Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors.forename: Horacio
authors.initials: H
authors.lastname: Senties
authors.affiliation: Department of Neurology, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, India.
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Thomas
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Jo
authors.initials: J
authors.lastname: Wilmshurst
authors.affiliation: Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jetté
mesh_terms: D026683:Advisory Committees / Q000592:standards / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D004827:Epilepsy / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D012955:Societies, Medical
keywords: Clinical practice guidelines; Epilepsy guidelines; Evidence-based medicine