A Nomogram to Predict Seizure Outcomes after Resective Epilepsy Surgery

预测癫痫切除手术后癫痫发作结果的列线图

• 批准号: 9308504
• 负责人: Lara Jehi
• 金额: $ 57.4万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9308504
• 关键词: Age; Anatomy; Applications Grants; Brain imaging; Caring; Characteristics; Classification; Clinic; Clinical; Complex; Convulsions; Counseling; Custom; Data; Decision Making; Development; Diagnostic; Diffusion Magnetic Resonance Imaging; Discrimination; Drug resistance; Electroencephalography; Epilepsy; Etiology; Evaluation; Excision; Family history of; Freedom; Frequencies; Functional Magnetic Resonance Imaging; Gene Targeting; Generic Drugs; Genetic; Goals; Gold; Handedness; Judgment; Lead; Lobe; Magnetic Resonance Imaging; Measurement; Measures; Methodology; Methods; Modeling; Multicenter Studies; Neurology; Nomograms; Operative Surgical Procedures; Outcome; Partial Epilepsies; Pathologic; Patient Care; Patients; Pattern; Performance; Physicians; Positron-Emission Tomography; Postoperative Period; Process; Prognostic Marker; Prospective cohort; Public Health; Publishing; Quantitative Evaluations; Recording of previous events; Recruitment Activity; Reproducibility; Resource Allocation; Rest; Retrospective cohort; Risk; Sampling; Seizures; Severity of illness; Site; Statistical Models; Supervision; Surgical Pathology; Testing; Time; Uncertainty; Universities; Validation; Work; base; cohort; gene panel; hazard; improved; individual patient; neuroimaging; outcome prediction; personalized medicine; predictive modeling; prognostic assays; prospective; sex; standard care; study population; success; tool; treatment choice; user-friendly

Project Summary: A patient currently considering epilepsy surgery receives counseling about his/her expected chances of seizure-freedom based on generic overall rates of success in large surgical cohorts. Answering the question of how “a patient like me” will do after surgery essentially depends on the physician's interpretation of complex pre-surgical testing: in fact, there is no objective, reproducible, and validated method to comprehensively combine the results of the pre-surgical work-up into an individualized outcome prediction. This uncertainty delays the initiation of surgical work-ups in patients who may benefit from epilepsy surgery, and may lead to redundant, risky, and futile testing in others who may actually not be good surgical candidates. This is a multi- center project building on an already developed statistical model, adding information from the fundamental components of any pre-surgical evaluation, including EEG, brain imaging, and clinical characteristics to develop an enhanced online tool called the “Epilepsy Surgery Nomogram” (ESN) allowing a tailored outcome prediction. Using the ESN, the physician treating a patient's epilepsy will be better able to assess the chances of seizure-freedom following epilepsy surgery, and will have a tool to assist decision-making by providing personalized and customized counseling. The goal will be to improve the care of patients with epilepsy by:1)- identifying surgical candidates earlier, and 2)- identifying complex cases needing a dedicated comprehensive epilepsy center more efficiently.

项目摘要： 目前正在考虑癫痫病的患者会收到有关其预期机会的咨询 基于大型手术队列成功的一般总体率。 手术后的“像我这样的病人”将如何取决于医师对复杂的解释 术前测试：实际上，没有客观，繁殖和经过验证 结合手术前的工作结果预测的结果 延迟可能受益于癫痫手术的患者的手术检查，并可能导致 实际上可能不是良好的手术候选者的其他人，这是多余的，风险和徒劳的测试。 Allyady开发了统计模型的中央项目大楼，添加了基本的信息 任何手术前评估的组成部分，包括脑电图，脑成像和临床特征 开发一种增强的在线工具，称为“癫痫手术列图”（ESN），允许量身定制的结果 预测。 癫痫手术后的癫痫发作，并将具有工具工具工具工具工具工具工具 个性化和定制的咨询将改善癫痫患者的护理：1） 识别手术候选者和2）dedicatiened Compuregension 癫痫中心更有效。