Related Experiment Video
Updated: May 27, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Is geographical variation in emergency epilepsy admissions related to variation in new epilepsy diagnoses among
Rakhee Shah1, Sandeepa Arora2, Colin Dunkley3
1Mohn Centre for Children's Health and Wellbeing, Department of Epidemiology and Biostatistics, Imperial College London, London, UK rakhee.shah@imperial.ac.uk.
Insights
Unexplained geographical variations in paediatric epilepsy admissions persist, as new diagnosis rates do not correlate with admission rates. This highlights potential inequities in epilepsy care access for children and young people.
Area of Science:
- Paediatric Neurology
- Health Services Research
- Epidemiology
Background:
- Previous research indicates significant unexplained geographical disparities in emergency paediatric epilepsy admissions.
- Understanding the drivers of these variations is crucial for improving healthcare equity.
Purpose of the Study:
- To investigate if geographical variations in emergency epilepsy admissions for children and young people (CYP) in England correlate with variations in new epilepsy diagnoses.
- To assess the relationship between admission and diagnosis rates across different hospital Trusts.
Main Methods:
- Retrospective analysis of Hospital Episode Statistics for emergency admissions (April 2018-March 2019) and Epilepsy12 audit data for new diagnoses (July-November 2018) in England.
- Calculation of observed-to-expected ratios for admissions and diagnoses, adjusted for age, sex, and deprivation.
- Correlation analysis (Pearson) between standardised admission and diagnosis ratios at the Trust level.
Main Results:
- Over 9000 emergency admissions for epilepsy in CYP were recorded across 134 Trusts.
- Nearly 45% of Trusts showed significantly higher or lower than expected epilepsy admission rates.
- No significant correlation was found between standardised epilepsy admission ratios and standardised new epilepsy diagnosis ratios (Pearson r = -0.06, p = 0.63).
Conclusions:
- Geographical variations in paediatric epilepsy admissions are not explained by variations in new epilepsy diagnoses.
- These findings raise concerns regarding the equity and accessibility of epilepsy services for children and young people.
- Benchmarking data on diagnoses and admissions can guide strategies to enhance care access and outcomes.
Introduction:
Previous studies have reported widespread unexplained geographical variations in emergency paediatric admissions for epilepsy.
Objectives:
Our aim was to investigate the extent to which geographical variation in epilepsy admissions among children and young people (CYP) aged 0-18 years, in England, reflects variation in new epilepsy diagnoses.
Design And Setting:
A retrospective secondary analysis of Hospital Episode Statistics data for emergency admissions between April 2018 and March 2019, and Epilepsy12 audit data for new epilepsy diagnoses in England, between July and November 2018.
Outcome Measures:
The ratios of observed to expected epilepsy admissions and new diagnoses were calculated for each hospital Trust, based on their catchment population, and adjusted for age, sex and deprivation. Standardised ratios of observed to expected epilepsy admissions were plotted against standardised ratios of observed to expected new diagnoses of epilepsy at Trust level and the Pearson correlation coefficient was calculated.
Results:
There were 9246 emergency admissions for CYP to 134 Trusts with a primary diagnosis of epilepsy in England during the study period. 60 Trusts (44.4%) had either significantly lower or higher than expected standardised admission ratios for a primary diagnosis of epilepsy. There were 960 new diagnoses of epilepsy between July and November 2018 for 74 Trusts. 14 Trusts (18.9%) had either lower or higher standardised diagnosis ratios for a new diagnosis of epilepsy. There was no correlation between standardised emergency epilepsy admissions ratios and standardised new epilepsy diagnoses ratios at Trust level (Pearson r -0.06, p 0.63).
Conclusions:
Widespread unexplained variation in epilepsy admissions cannot be explained by variation in new epilepsy diagnosis. This raises concerns about the equity and accessibility of epilepsy services. Unit-level benchmarking data on new diagnoses and admissions for epilepsy can inform strategies to improve access to care and health outcomes.
More Related Videos
10:46Author Spotlight: Obtaining High-Quality CSF and Blood Samples for Epilepsy Biomarker Discovery
Published on: September 1, 2023
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
Related Concept Videos
01:24Arteries of the Lower Limbs
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types: