Definition of new‐onset epilepsy versus newly diagnosed epilepsy: Role of time domain
Bibliographic record
Abstract
To the Editors: We were very pleased to see the recent article “Standards for Epidemiological Studies and Surveillance of Epilepsy” and with the fact that the commission in charge distinguished between newly diagnosed epilepsy (NDE) and new-onset epilepsy (NOE) (Thurman et al., 2011) which, in our opinion, reflects different concepts and dynamics of epilepsy. “The magnitude of the incidence of new onset epilepsy and the incidence of newly diagnosed epilepsy will differ, because the measures have different numerators. For new onset epilepsy, the numerator includes people identified at their second unprovoked seizure. In contrast, the numerator for newly diagnosed epilepsy (NDE) includes both new onset epilepsy and people with more than two unprovoked seizures who are first diagnosed with epilepsy during the study period…”, p. 14. We have two comments from our side. First, we were wondering, on which data this definition is based and if a reference could be provided for this important definition. Secondly, we would like to suggest implementation of a time domain in the definitions of NOE and NDE, rather than the absolute number of seizures, which often is hard to assess and speculative. In our own First Seizure Clinic we decided to use the term new-onset epilepsy for any patient with evidence of two or more seizures within the last 12 months. Patients with their first generalized tonic–clonic seizure and preceding epigastric auras for a couple of months (up to a maximum 12 months prior) are accordingly diagnosed with NOE. We also see NOE as a subcategory of NDE. We diagnose newly diagnosed epilepsy if there is evidence of ongoing seizures for more than 1 year. Often these patients have undiagnosed seizures for a decade or more. We believe that “our definition” better addresses the different stages of epilepsy. We would be highly interested in the commission’s opinion on our approach and if we could arrive at a consensus on these crucial definitions. None of the authors has any conflict of interest to disclose. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.161 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.006 |
| Scholarly communication | 0.009 | 0.009 |
| Open science | 0.006 | 0.003 |
| Research integrity | 0.012 | 0.031 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".