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Lin M, Chen J, Li S, Qin Y, Wang X, Liu Y, Zhang Q, Taha Abdullah Abdulaziz A, Zhou D, Li J. Individual prediction of motor vehicle accidents for patients with epilepsy. Epilepsy Behav 2021; 121:108046. [PMID: 34111767 DOI: 10.1016/j.yebeh.2021.108046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The objective of the study was to design a clinically useful tool to predict the risk of seizure-related motor vehicle accidents (MVAs) for people with epilepsy (PWE). Participants were patients who visited our epilepsy center in West China Hospital from October 2012 to October 2019 and were divided into a primary cohort and a validation cohort. Ultimately, we included 525 patients in the primary cohort and 86 patients in the validation cohort. Proportional hazard regression was performed to measure the prognostic factors of car accidents. The outcome was used to create a nomogram model. The final model had 7 factors, with a C-index of 0.85 (95% CI, 0.80-0.91), to predict the possibility of non-MVA for PWE. For the validation cohort, the C-index was 0.83 (95% CI, 0.72-0.95). This nomogram model can offer more individualized advice to PWE who are still driving by estimating the risk of car accidents.
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Affiliation(s)
- Mintao Lin
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Jiani Chen
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Sisi Li
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Yingjie Qin
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Xuruan Wang
- West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Yadong Liu
- West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Qi Zhang
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Ammar Taha Abdullah Abdulaziz
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China.
| | - Jinmei Li
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China.
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Lee SA. Physicians' attitudes toward driving by persons with epilepsy in Korea: 2009 versus 2017 survey. Epilepsy Behav 2021; 116:107733. [PMID: 33515933 DOI: 10.1016/j.yebeh.2020.107733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/20/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This study compared physicians' attitudes toward the fitness of persons with epilepsy to drive between 2009 and 2017 in Korea. METHODS A questionnaire focusing on physicians' opinions about driving issues for persons with epilepsy was developed from literature reviews. Korean physicians were then surveyed anonymously via the online questionnaire in 2009 and in 2017. RESULTS The numbers of valid respondents were 118 in 2009 and 160 in 2017. The majority of respondents were neurologists. The preferred criterion for eligibility to drive in both surveys was 2 years free from seizure (41.5% in 2009 and 45.6% in 2017). However, the minimum seizure-free criterion for driving eligibility declined between 2009 and 2017. The changes in attitudes toward driving were significant only among physicians who had more than 10 patients with epilepsy per week. However, the proportion of physicians who agreed with 6-month seizure freedom as a criterion for fitness to drive was lower in 2017 than in 2009. CONCLUSIONS Although the preference of a 2-year seizure-free period as a criterion for fitness to drive did not change between 2009 and 2017, the minimum criterion for the seizure-free period did decline, particularly among physicians who had more than 10 patients with epilepsy per week in their clinic. The data support sustained efforts to promote education regarding aspects of epilepsy related to driving.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Facilitating ethical, legal, and professional deliberations to resolve dilemmas in daily healthcare practice: A case of driver with breakthrough seizures. Epilepsy Behav 2020; 102:106703. [PMID: 31786471 DOI: 10.1016/j.yebeh.2019.106703] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The present study was conducted among pharmacy students to use an 8-step systematic approach to facilitate discussions, deliberations, and decision-making on what to do when facing a dilemma of a patient with epilepsy who drives while having breakthrough seizures. METHODS A hypothetical case was developed using the 12-tips for developing dilemma case-based assessments in health education. A mixed method was used in this study. A serial group discussions based on the nominal group technique (NGT) method were applied. A thorough review of the literature and interviews with key experts in the domain (n = 12) were conducted to obtain pertinent data to inform discussions, deliberations, and decision-making. The analytic hierarchy process (AHP) was used to pairwise compare countervailing arguments and alternative courses of action. RESULTS In this study, 3 nominal groups were held, and for each 3, discussion rounds were conducted. A total of 27 panelists took part in the nominal groups. Compared with other alternative courses of action, significantly higher weight scores (p-value < 0.001) were given to the course action, "the pharmacist could counsel/educate the patient on the dangers/risks of driving while experiencing breakthrough seizures, inform the patient to refrain from driving in this period, and make a shared decision with the patient to refrain from driving in this period and inform the state authorities". CONCLUSION This study demonstrates that the 8-step approach when combined with the AHP can be a handy method in facilitating decision-making while addressing and resolving ethical/legal/professional dilemmas in daily healthcare practice.
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Okumura A, Abe S, Nakazawa M, Ikeno M, Igarashi A, Takasu M, Shimizu T. Attitudes toward driver's licenses for people with epilepsy: 2012 versus 2014. Pediatr Int 2017; 59:185-189. [PMID: 27468704 DOI: 10.1111/ped.13104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND We compared knowledge about and attitudes toward epilepsy and the issuing of driver's licenses to people with epilepsy among non-medical students before and after media controversies. METHODS The survey was performed in 2012 and 2014 using a structured questionnaire. Participants were non-medical students who attended a lecture on neurological diseases in children. The proportion of positive answers to each question in 2012 was compared with that in 2014. In addition, questions regarding attitudes toward driver's licenses were compared according to knowledge about car accidents linked to people with epilepsy. RESULTS More participants were familiar with epilepsy and had a favorable attitude toward epilepsy in 2014 than in 2012. In contrast, the proportion of participants who knew of car accidents linked to people with epilepsy was reduced in 2014 compared with 2012. The proportion of participants who did not think that severe punishment should be given to people with epilepsy if they caused a car accident decreased in 2014 among those without knowledge of car accidents. CONCLUSIONS Familiarity with and attitudes toward epilepsy were improved in 2014, whereas the decrease in proportion of positive answers on punishment among participants unfamiliar with car accidents suggests a latent worsening of public attitudes.
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Affiliation(s)
- Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan.,Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shinpei Abe
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mika Nakazawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mitsuru Ikeno
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ayuko Igarashi
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Michihiko Takasu
- Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan.,Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
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Okumura A, Abe S, Kurahashi H, Takasu M, Ikeno M, Nakazawa M, Igarashi A, Shimizu T. Worsening of attitudes toward epilepsy following less influential media coverage of epilepsy-related car accidents: An infodemiological approach. Epilepsy Behav 2016; 64:206-211. [PMID: 27744246 DOI: 10.1016/j.yebeh.2016.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/17/2016] [Accepted: 09/17/2016] [Indexed: 12/24/2022]
Abstract
To evaluate changes in the attitudes of nonmedical university students toward epilepsy in 2015, the present study compared the results of questionnaire surveys from four different time periods: before media coverage of epilepsy-related car accidents (2008-2010), during a period of abundant media coverage (2011-2012), after media coverage (2013-2014), and after novel media coverage (2015). The nonmedical students that completed the questionnaire were divided into four groups: 2008-2010, 2011-2012, 2013-2014, and 2015. The rates of students that had read or heard about epilepsy decreased significantly in 2015 compared with those in 2013-2014. Attitudes toward epilepsy had also worsened in 2015. The rates of students that would not oppose their children playing with or attending school alongside children with epilepsy and those who thought that people with epilepsy should be hired in the same way as other people had decreased significantly in 2015 compared with those in 2011-2012 and 2013-2014. Analyses of information-seeking behavior on the Internet showed that the increase in Google search volume and Wikipedia page views was much less in 2015 than in 2011 and 2012. These findings suggest that familiarity with epilepsy had worsened even after media coverage of novel epilepsy-related car accidents. This suggests that media coverage in 2015 was less influential than that in 2011 and 2012.
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Affiliation(s)
- Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Japan; Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
| | - Shinpei Abe
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | | | | | - Mitsuru Ikeno
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Mika Nakazawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Ayuko Igarashi
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
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