TY - JOUR
T1 - Dilemmas in the interpretation of diagnostic accuracy studies on presurgical workup for epilepsy surgery
AU - Burch, Jane
AU - Marson, Anthony
AU - Beyer, Fiona
AU - Soares, Marta
AU - Hinde, Sebastian
AU - Wieshmann, Udo
AU - Woolacott, Nerys
N1 - Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.
PY - 2012/8
Y1 - 2012/8
N2 - We conducted a systematic review to determine which noninvasive technologies should be used in the workup for epilepsy surgery to identify structural or functional abnormalities to help locate the site of seizure onset. The review focused on patients where there was insufficient confidence, in either the decision to go to surgery or the site at which surgery should be conducted, after the initial clinical examination. The majority of the studies identified were single-gate diagnostic accuracy studies; none were randomized controlled trials, and only one reported the effect of the test results on the decision making process. It became apparent that the data derived from diagnostic accuracy studies could not be used to answer the review question. This article focuses on the methods used to extract data from the diagnostic accuracy studies, the difficulties interpreting the resulting data, why such studies are not an appropriate study design in this setting, and how the evidence-base can be improved.
AB - We conducted a systematic review to determine which noninvasive technologies should be used in the workup for epilepsy surgery to identify structural or functional abnormalities to help locate the site of seizure onset. The review focused on patients where there was insufficient confidence, in either the decision to go to surgery or the site at which surgery should be conducted, after the initial clinical examination. The majority of the studies identified were single-gate diagnostic accuracy studies; none were randomized controlled trials, and only one reported the effect of the test results on the decision making process. It became apparent that the data derived from diagnostic accuracy studies could not be used to answer the review question. This article focuses on the methods used to extract data from the diagnostic accuracy studies, the difficulties interpreting the resulting data, why such studies are not an appropriate study design in this setting, and how the evidence-base can be improved.
UR - http://www.scopus.com/inward/record.url?scp=84865031397&partnerID=8YFLogxK
U2 - 10.1111/j.1528-1167.2012.03534.x
DO - 10.1111/j.1528-1167.2012.03534.x
M3 - Article
C2 - 22690650
VL - 53
SP - 1294
EP - 1302
JO - Epilepsia
JF - Epilepsia
IS - 8
ER -