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The current state of epilepsy guidelines: A systematic review
Khara M Sauro1,2, Samuel Wiebe1,2, Colin Dunkley3
1Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Epilepsia
|December 15, 2015
Summary
This systematic review identified gaps and quality variations in international epilepsy clinical care guidelines. Findings will help prioritize and develop future epilepsy guidelines for better patient care.
Area of Science:
- Neurology
- Clinical Practice Guidelines
- Systematic Review
Background:
- The International League Against Epilepsy (ILAE) established a task force in 2011 to systematically review global epilepsy clinical care guidelines.
- The objective was to assess guideline quality and identify areas needing development.
Purpose of the Study:
- To identify and evaluate the quality of international epilepsy clinical care guidelines.
- To determine gaps in existing guidelines for epilepsy management.
Main Methods:
- A systematic literature review (1985-2014) was conducted across six electronic and six gray literature databases.
- Abstracts were screened, full-text articles reviewed, and data abstracted by two independent reviewers.
- Descriptive statistics and meta-analysis were employed.
Main Results:
- 10,926 abstracts were identified, with 63 guidelines meeting eligibility criteria.
- Guidelines varied in focus (adults, children, women) and topic (status epilepticus, first seizure, drug-resistant epilepsy).
- Moderate overall quality (mean score 4.99/7) with significant heterogeneity was observed.
Conclusions:
- Substantial gaps exist in epilepsy guideline topics, such as epilepsy in the elderly.
- Considerable heterogeneity in methodological quality necessitates improvement.
- These findings will guide the development and dissemination of future epilepsy guidelines.
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