title: Development of the Epilepsy Risk Awareness scale (ERA scale) for people with epilepsy.
abstract: OBJECTIVE
  Quality of life in people with epilepsy depends on balancing protection from risks and avoiding unnecessary restrictions. The Epilepsy Risk Awareness Checklist (ERAC) was developed to summarise an individual's safety, health care and quality of life and to facilitate communication between professionals. Although effective, the existing Checklist required quantification and shortening to increase its utility, particularly as a longitudinal tool for measuring and communicating changes over time.
  
  
  METHODS
  5 clinical experts, 3 people with epilepsy and 5 carers assessed the importance of each item on the ERAC questionnaire in a two-round Delphi survey. The refined Epilepsy Risk Awareness scale (ERA scale) was piloted in 30 patients to obtain an overall and sub-scale score for personal safety, health care, and quality of life domains, and was compared with the validated Seizure Severity Scale and Epilepsy Self-Management Scale.
  
  
  RESULTS
  ERAC was shortened from 69 to 48 items to take 15-20min for completion. Pilot results showed good internal consistency for the overall ERA scale, for the Personal Safety and Health Care subscales, but less for the Quality of Life subscale. There was strong association between ERA scale and the Epilepsy Self-Management Scale, but little relationship with Seizure Severity Scale scores, which focus on individual seizures. User ratings were high.
  
  
  CONCLUSIONS
  The ERA scale has been shortened and quantified to provide an objective measure of the risks and safety profile in people with epilepsy. The scale will be further tested for intra-rater variability and utility.
authors.affiliation: Centre for Research in Primary and Community Care, University of Hertfordshire, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Braun
authors.affiliation: CHSS, University of Kent, Canterbury, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Kendall
authors.affiliation: Central London Community Healthcare Trust, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Cole
authors.affiliation: Centre for Research in Primary and Community Care, University of Hertfordshire, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Smeeton
authors.affiliation: Epilepsy Initiative Group, Royal Free London NHS Foundation Trust and University College London, UK. Electronic address: heather.angus-leppan@nhs.net.
authors.forename: Heather
authors.initials: H
authors.lastname: Angus-Leppan
mesh_terms: D000328:Adult; D001364:Awareness; D017028:Caregivers; D057189:Checklist; D003142:Communication; D003697:Delphi Technique; D004827:Epilepsy / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D061214:Patient Safety; D010865:Pilot Projects; D011788:Quality of Life; D015203:Reproducibility of Results; D012306:Risk; D013997:Time Factors
keywords: Checklist; Epilepsy; Health care; Personal safety; Quality of life; Risk; Scale; Seizure