The Long-Term Outcome of Children with Refractory Epilepsy after a Vagal Nerve Stimulator Implantation: CHU Sainte-Justine Experience (P5.251)
Bibliographic record
Abstract
Objective:The aim of our study was to evaluate the impact of VNS after five years of follow up on seizure frequency and admission and emergency visit rates in children with refractory epilepsies. Background:Debate persists in Canada about the cost:benefit ratio of vagal nerve stimulation (VNS) in patients with refractory epilepsy. However very few studies have addressed its long-term effectiveness beyond 24 months and none in a solely pediatric population. Methods:52 patients were implanted between 2000-2010. Of these, 31 were followed at CHU Sainte-Justine and 21 kept seizure diaries. Seizure frequency was compared at baseline, 6, 12, 24 and 60 months of follow up using a multivariate ANOVA analysis. The hospitalization and emergency visit rates were calculated as the incidence between epilepsy onset and implantation and between implantation and last follow up. Results:Seizure frequency decreased by 58[percnt] at 6, 61[percnt] at 12, 53[percnt] at 24 and 63[percnt] at 60 months of follow up respectively (p< 0.001). The hospitalization and emergency visit rates decreased by 48.22 [percnt] and 30.27 [percnt] respectively (p< 0.001). The hospitalization rates after the implantation were constant without a significant difference between years. Conclusions:: In our population, VNS has a sustained impact on seizure frequency and hospitalization and emergency visit rates. This supports previous data from our group and others on the cost-effectiveness of the technique in children with refractory epilepsy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".