Skip to main content
SpringerLink
Log in

Diagnostic Reference Frames for Seizures:

A validation study

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Introduction

We developed structured descriptions of signs and symptoms for specific seizure types (called Diagnostic Reference Frames—DRFs—by us) that can serve as a frame of reference in the process of classifying patients with epileptic seizures. In this study the validity of the DRFs for clinical use is evaluated and described.

Material and methods

In this study we use a decision support system based on the DRFs and using Bayes's rule for the validation of the DRFs. Patient's manifestations are entered in the decision support system and by successively applying Bayes's rule posterior probabilities are calculated. The DRFs with the highest posterior probability gives an indication of the classification of the seizure. The validation of the DRFs was performed by comparing the seizure type with the highest posterior probability with the classification of experienced epileptologists on a series of test cases with known epileptic seizures. In this way we assessed the accuracy of the DRFs in classifying patients with epileptic seizures.

Results

We included sixty–six patients in this efficacy study. The patients and/or their relatives described the manifestations occurring during a seizure. Sixty cases (91%) were correctly classified using the decision support system.

Discussion

The accuracy of 91 % indicates that the knowledge encoded in the DRFs for the included seizure types is valid. The next step is to test the DRFs in a clinical setting to evaluate the applicability in daily practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Commission on Classification and Terminology of the International League Against Epilepsy (1981) Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 22:489–501

    Google Scholar 

  2. Gastaut H (1970) Clinical and electroencephalographical classification of epileptic seizures. Epilepsia 11:102–113

    CAS  PubMed  Google Scholar 

  3. Bodensteiner JB, Brownsworth RD, Knapik JR, Kanter MC, Cowan LD, Leviton A (1988) Interobserver variability in the ILAE classification of seizures in childhood. Epilepsia 29:123–128

    CAS  PubMed  Google Scholar 

  4. Van Donselaar CA, Geerts AT, Meulstee J, Habbema JD, Staal A (1989) Reliability of the diagnosis of a first seizure. Neurology 39:267–271

    CAS  PubMed  Google Scholar 

  5. Reutens DC, Howell RA, Gebert KE, Berkovic SF (1992) Validation of a questionnaire for clinical seizure diagnosis. Epilepsia 33:1065–1071

    Article  CAS  PubMed  Google Scholar 

  6. Sander JW, Shorvon SD (1987) Incidence and prevalence studies in epilepsy and their methodological problems: a review. J Neurol Neurosurg Psychiatry 50:829–839

    CAS  PubMed  Google Scholar 

  7. Engelbrecht R, Rector A, Moser W (1995) Verification and validation. In: Van Gennip EMS, Talmon JL (eds) Assessment and evaluation of information technologies. Amsterdam: IOS Press; pp 51–66

  8. Van Ast JF, Talmon JL, Renier WO, Hasman A (2004) An approach to knowledge base construction based on expert opinions. Methods Inf Med 43:427–432

    CAS  PubMed  Google Scholar 

  9. Brender J, Talmon J, Nykanen P, Mc– Nair P, Demeester M, Beuscart R (1995) On the evaluation of system integration. In:Van Gennip EMS, Talmon JL (eds) Assessment and evaluation of information technologies. Amsterdam: IOS Press; pp 189–208

  10. Rector AL, Ackerman E (1975) Rules for sequential diagnosis. Comput Biomed Res 8:143–155

    Article  CAS  PubMed  Google Scholar 

  11. Gorry GA, Barnett GO (1968) Sequential diagnosis by computer. JAMA 205:849–854

    Article  CAS  PubMed  Google Scholar 

  12. Nøhr C (1995) From assessment to decision– making. In:Van Gennip EMS, Talmon JL (eds) Assessment and evaluation of information technologies. Amsterdam: IOS Press; pp 117–126

  13. Commission on Classification and Terminology of the International League Against Epilepsy (1989) Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 30:389–399

    Google Scholar 

  14. Korpinen L, Pietila T, Peltola J, Nissila M, Keranen T, Touvinen T, Petranek ES, Frey H (1994) Evaluation of Epilepsy Expert–a decision support system. Comput Methods Programs Biomed 45:223–231

    Article  CAS  PubMed  Google Scholar 

  15. Spitzer K, Thie A, Caplan LR, Kunze K (1989) The MICROSTROKE expert system for stroke type diagnosis. Stroke 20:1353–1356

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Maastricht, Research Institute Caphri, Department of Medical Informatics, 616, 6200 MD, Maastricht, The Netherlands

    J. F. van Ast, J. L. Talmon & J. M. A. Roos

  2. Department of Child Neurology, University Medical Center St. Radboud, 9101, CZZO 326, 6500 HB, Nijmegen, The Netherlands

    W. O. Renier

  3. Department of Medical Informatics, Academic Medical Center Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam Z.O, The Netherlands

    A. Hasman

Authors
  1. J. F. van Ast
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. O. Renier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. L. Talmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. M. A. Roos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Hasman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. F. van Ast.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Ast, J.F., Renier, W.O., Talmon, J.L. et al. Diagnostic Reference Frames for Seizures:. J Neurol 253, 372–376 (2006). https://doi.org/10.1007/s00415-005-0011-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-005-0011-0

Key words

Search

Navigation