A Novel Parent Questionnaire for the Detection of Seizures in Children

• Published in: Pediatric neurology 2016-01, Vol.54, p.64-69.e1
• Main Authors: Douglass, Laurie M., MD, Kuban, Karl, MD, Tarquinio, Daniel, DO, Schraga, Leah, MD, Jonas, Rinat, MD, Heeren, Timothy, PhD, DeBassio, William A., PhD, MD, Stafstrom, Carl E., MD, PhD, Heinrick, Ryan John, MD, Ferguson, Chantal, Blumberg, Lauren, Wong, Vanessa
• Format: Article
• Language: English
• Subjects: Algorithms; Child; Child, Preschool; children; Computers; Decision Support Systems, Clinical; Diagnosis, Computer-Assisted - methods; Electroencephalography; epilepsy; False Positive Reactions; Female; Humans; Infant; Male; Neurology; parent; Parents; pediatric; Pediatrics; Prevalence; questionnaire; Risk; ROC Curve; seizure; Seizures - diagnosis; Seizures - epidemiology; Seizures - physiopathology; Sensitivity and Specificity; Single-Blind Method; survey; validation studies
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2015.09.016

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.