Use of Recommended Neurodiagnostic Evaluation Among Patients With Drug-Resistant Epilepsy
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.Patients with drug-resistant epilepsy (DRE) often do not receive recommended neurodiagnostic evaluations. Evaluation rates varied significantly by care setting and insurance type, highlighting a gap in best practice adherence.
Area Of Science
- Neurology
- Epilepsy Research
- Health Services Research
Background
- Interdisciplinary guidelines recommend comprehensive neurodiagnostic evaluation for drug-resistant epilepsy (DRE).
- Specialized centers report delays and underuse of presurgical evaluations for DRE.
- Limited longitudinal data exist on DRE neurodiagnostic evaluation in diverse US settings.
Purpose Of The Study
- To determine the rate of neurodiagnostic studies and comprehensive evaluations for DRE patients.
- To identify factors associated with receiving these evaluations across different US healthcare settings.
Main Methods
- Retrospective cross-sectional study using the Observational Medical Outcomes Partnership Common Data Model.
- Included US Medicaid, commercial claims, and electronic health record data (Columbia University Medical Center).
- Analyzed patients meeting a DRE computable phenotype algorithm between 2015-2020.
Main Results
- Comprehensive evaluation rates were low: 4.5% (Medicaid), 8.0% (commercial), and 14.3% (CUMC).
- Video electroencephalography and MRI brain were more common than neuropsychological evaluation or advanced imaging.
- Higher frequency of nonemergency epilepsy visits and focal epilepsy were associated with increased evaluation rates.
Conclusions
- A significant gap exists in the utilization of recommended diagnostic studies for DRE patients.
- Care setting, insurance type, visit frequency, and epilepsy type influence evaluation rates.
- Common data models can track adherence to best practices across diverse data sources.
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
Related Concept Videos
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...