An Observational Study of an Epilepsy Monitoring Unit in a Level 4 Epilepsy Center, Post-Implementation of the National Association of Epilepsy Centers 2010 Revised Guidelines
Bibliographic record
Abstract
Background: Of the 2.7 - 3.4 million Americans estimated to have some form of epilepsy, approximately 25-30% of these individuals do not have adequate seizure control and suffer from intractable epilepsy. The objective of this study was to report outcomes of patients with epilepsy monitoring unit (EMU) admissions using data from a level 4 epilepsy center. Methods: We performed a retrospective review of electronic medical records for 433 EMU patient visits between January 2016 and May 2019 at a level 4 comprehensive epilepsy center. The EMU protocols followed in these admissions were those listed in the guidelines by the National Association of Epilepsy Centers (NAEC). Patients were monitored by a medical team that included electroencephalogram technicians, neurophysiologists, and epileptologists. Results: Of the 433 patients assessed, 384 met inclusion criteria. Mean length of stay in the EMU was 4 days. Of the patients, 73.4% had EMU stays resulting in new information which led to interventions including further diagnostic testing, surgical treatment, and medication changes. The most frequent intervention was a change in medication (68.8% of patients). Of the patients, 90.1% received a definitive diagnosis at the conclusion of their admission, with the most common diagnosis being epileptic seizures (66.7%), followed by non-epileptic physiologic events (14.3%) and psychogenic non-epileptic seizures (8.6%). Conclusions: This study sought to describe outcomes from patients who stayed in our level 4 epilepsy center’s EMU after the implementation of the revised NAEC guidelines made in 2010. We investigated patient demographics as well as diagnosis and/or treatment changes after the EMU stay. We conclude that under the new NAEC guidelines, an EMU admission remains diagnostically useful in identifying if a patient has epilepsy or not. Our goal for this retrospective review is to inform future prospective outcomes studies and add to the body of literature demonstrating an EMU evaluation as a valuable diagnostic tool for epilepsy patients. J Neurol Res. 2021;11(5):87-93 doi: https://doi.org/10.14740/jnr703
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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 | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".