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Clinician Feedback Regarding Novel Graphical Risk Prediction Tools for Antiseizure Medication Discontinuation: A
Samuel W Terman1, Navya Kalia2, Max Kuster3
1Department of Neurology, University of Michigan, Ann Arbor.
Neurology. Clinical Practice
|October 15, 2025
Summary
Clinicians have mixed views on seizure risk prediction tools. Graphical displays may offer advantages over numerical outputs for shared decision-making in epilepsy treatment.
Area of Science:
- Neurology
- Medical Informatics
- Decision Science
Background:
- Discontinuing antiseizure medication (ASM) after seizure freedom is challenging.
- Risk prediction tools can aid shared decision-making for ASM discontinuation.
- End-user stakeholder engagement is crucial for developing effective tools.
Purpose of the Study:
- To examine clinician views on novel, graphically based seizure risk prediction tools.
- To gather feedback on preferred formats for seizure risk communication.
Main Methods:
- Qualitative study using 6 focus groups with 25 neurologists (epileptologists and general neurologists).
- Purposive sampling from diverse geographical settings.
- Verbatim transcription and deductive/inductive analysis of feedback on proposed tools.
Main Results:
- Clinician preferences for risk prediction outputs were mixed: some favored numerical calculators, while others preferred graphical displays.
- Graphical formats like cumulative incidence functions and pictographs were suggested for clinician and patient use, respectively.
- Suggested alternative formats included 'stoplight' displays and decision charts; confidence intervals were seen as potentially cluttering.
Conclusions:
- Clinician feedback is vital for guiding the development of seizure risk prediction tools.
- Graphical displays offer potential advantages in clarity and information conveyance over numerical outputs, though preferences vary.
- Future tool development should consider incorporating clinician preferences and will require patient input.
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