Development and validation of AIIMS modified INCLEN diagnostic instrument for epilepsy in children aged 1 month-18 years.
There is shortage of specialists for the diagnosis of children with epilepsy, especially in resource limited settings. Existing INCLEN (International Clinical Epidemiology Network) instrument was validated for children aged 2-9 years. The current study validated modifications of the same including wider symptomatology and age group.



The Modified INCLEN tool was validated by a team of experts by modifying the existing tools (2-9 years) to widen the age range from 1 month to 18 years and include broader symptomatology in a tertiary care teaching hospital of North India between January and June 2015. A qualified medical graduate applied the candidate tool which was followed by gold standard evaluation by a Pediatric Neurologist (both blinded to each other).



A total of 197 children {128 boys (65%) and 69 girls (35%)}, with a mean age of 72.08 (±50.96) months, completed the study. The sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio of the modified epilepsy tool were 91.5% (84.5-96.1), 88.6% (80.0-93.5), 89.7% (81.9-95.3), 90.8% (83.7-95.7), 8 (6.6-9.8) and 0.09 (0.07-0.12) respectively.



The new modified diagnostic instruments for epilepsy is simple, structured and valid instruments covering 1month to 18 years for use in resource limited settings with acceptable diagnostic accuracy. All seizure semiologies as well as common seizure mimics like breath-holding spells are included in the tool. It also provides for identification of acute symptomatic and febrile seizures.
Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029 India. Electronic address: sheffalig@yahoo.com.
Sheffali
S
Gulati
Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029 India.
Harsh
H
Patel
Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029 India.
Biswaroop
B
Chakrabarty
Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029 India.
Rachana
R
Dubey
INCLEN Trust, New Delhi, India.
N K
NK
Arora
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
R M
RM
Pandey
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
V K
VK
Paul
Rainbow Children Hospital, Hyderabad, India.
Konanki
K
Ramesh
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Vyshakh
V
Anand
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Ankit
A
Meena
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D016013:Likelihood Functions; D008297:Male; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology; D012680:Sensitivity and Specificity
AIIMS; Epilepsy tool; INCLEN; Modification; Validation