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Adapted Evidence-Based Clinical Practice Guidelines for Diagnosis and Treatment of Epilepsies in Children: A Tertiary
Shimaa A M Anwar1, Elham E Elsakka1, Mona Khalil1
1Paediatric Neurology Unit, Faculty of Medicine, Paediatrics Department, Alexandria University, Alexandria, Egypt.
Insights
This study updated clinical practice guidelines for diagnosing and treating childhood epilepsy, unifying care standards. The revised guidelines offer comprehensive, evidence-based recommendations for healthcare providers to improve patient outcomes.
Area of Science:
- Pediatric Neurology
- Clinical Practice Guidelines
- Evidence-Based Medicine
Background:
- Medical knowledge evolves, necessitating regular updates to clinical practice guidelines (CPGs) for optimal patient care.
- Alexandria University Children Hospital (AUCH) sought to unify and standardize the diagnosis and treatment of childhood epilepsy by updating existing CPGs from 2014 and 2016.
Approach:
- A Guideline Review Group (GRG) updated CPGs using a high-quality source from the Scottish Intercollegiate Guidelines Network (SIGN).
- The GRG employed the Checklist for the Reporting of Updated Guidelines (CheckUp) and the RIGHT-Ad@pt Checklist for adapted CPGs.
- Recommendations were reviewed and updated across 10 key categories, covering the full spectrum of epilepsy management in children.
Key Points:
- The updated CPG integrates diagnosis, pharmacological and non-pharmacological treatments, pharmacoresistant epilepsy management, and care for special populations.
- Key areas include medication management, patient and caregiver education, comorbidity management, and transitional care from pediatric to adult services.
- The process highlighted the value of collaborative expert groups and standardized reporting tools for CPG updates.
Conclusions:
- The finalized CPG provides AUCH healthcare providers with evidence-based guidance for diagnosing and managing childhood epilepsy.
- This update standardizes care, aiming for improved outcomes in pediatric epilepsy management.
- The study underscores the importance of collaborative efforts and validated tools in the CPG update process.
Hypothesis And/Or Background:
We recently updated and merged the adapted clinical practice guidelines (CPGs) for the diagnosis and treatment of children with epilepsy of a tertiary-level hospital. Medical knowledge is always evolving. As a result, it is critical to revisit the clinical standards on a frequent basis to ensure that the best services are offered to the target receivers. The purpose of this article was to update and merge the CPGs at Alexandria University Children Hospital (AUCH) for the diagnosis (2014) and treatment (2016) of children with epilepsy to unify and standardize the practice for better care and outcome.
Methods:
This review and update CPG project was initiated by assembling a Guideline Review Group (GRG). The GRG conducted focus group discussions and decided to search any published updates of the recommendations of the previously identified high-quality and evidence-based CPG developed by the SIGN (Scottish Intercollegiate Guidelines Network) and to merge the two previous local CPGs under one comprehensive CPG for full management of epilepsy in children. The high quality of the selected source CPG from SIGN was based on quality assessment of CPGs undertaken previously using the Appraisal of Guidelines for Research and Evaluation II Instrument. The GRG followed the Checklist for the Reporting of Updated Guidelines (CheckUp), which is the CPG tool recommended by the Enhancing the Quality and Transparency of health Research Network for reporting of updated CPGs in addition to the RIGHT-Ad@pt Checklist for Adapted CPGs. The finalized updated CPG draft was sent to the external reviewer group topic experts.
Results:
The group updated 10 main categories of recommendations from one source CPG (SIGN). The recommendations included (1) epilepsy diagnosis; (2) recognition, identification, and referral; (3) pharmacological treatment of epilepsy and epilepsy syndromes; (4) nonpharmacological treatment of epilepsy and epilepsy syndromes; (5) managing pharmacoresistant epilepsy; (6) management of epilepsy in special groups; (7) medications; (8) children and caregiver education and support; (9) comorbidities and mortality; and (10) transitional care from pediatric to adult care services.
Conclusions:
The finalized CPG provides evidence-based guidance to health care providers in AUCH for the diagnosis and management of epilepsy in children. The study also established the significance of a collaborative clinical and methodological expert group for the update of CPGs, as well as the usability of the "CheckUp" and "RIGHT-Ad@pt" CPG Tools.
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