Showing papers by "John T. Langfitt published in 2000"

Relationships Between Seizure Severity and Health-Related Quality of Life in Refractory Localization-Related Epilepsy

Abstract: Summary: Purpose: To evaluate relationships between self-report measures of seizure severity and health-related quality of life (HRQOL) in people with refractory localization-related epilepsy. Methods: A sample of 340 adults enrolled in a seven-center, prospective study of resective epilepsy surgery completed baseline questionnaires that included the Quality of Life in Epilepsy (QOLIE)-89 and a seven-item adaptation of the National Hospital Seizure Severity Scale. Associations between QOLIE-89 summary measures and both the total seizure severity scale score and individual seizure severity items were assessed, after adjustment for seizure frequency. Results: The seizure severity measure had adequate scale score variability and reliability in this sample. Correlations between individual items in the scale did not exceed 0.43. Product-moment partial correlations between the seizure severity scale and QOLIE-89 summary measures ranged from −0.17 to −0.29 (all p values <0.01). Of the seven seizure severity items, the average time before individuals perceived they were “really back to normal” after their seizures was broadly related to all domains of HRQOL (r values ranged from −0.16 to −0.30; p values <0.01). Severity of injury during seizures was the only other item having more than minimal associations with HRQOL, and it was selectively related to the physical health measure. Higher frequency of falls during seizures was modestly related to less employment. Conclusions: This seizure severity measure assesses constructs that are generally distinct from HRQOL, except for moderate and broad associations between HRQOL and patient's perceptions of the average duration of recovery time after seizures. Recovery time may potentially be a useful clinical indicator of seizure severity that reflects meaningful impairment of HRQOL in adults with frequent seizures.

Clinical Research Relationships Between Seizure Severity and Health-Related Quality of Life in Refractory Localization-Related Epilepsy

Abstract: Summary: Purpose: To evaluate relationships between selfreport measures of seizure severity and health-related quality of life (HRQOL) in people with refractory localization-related epilepsy. Methods: A sample of 340 adults enrolled in a seven-center, prospective study of resective epilepsy surgery completed baseline questionnaires that included the Quality of Life in Epilepsy (Q0LIE)-89 and a seven-item adaptation of the National Hospital Seizure Severity Scale. Associations between QOLIE-89 summary measures and both the total seizure severity scale score and individual seizure severity items were assessed, after adjustment for seizure frequency. Results: The seizure severity measure had adequate scale score variability and reliability in this sample. Correlations between individual items in the scale did not exceed 0.43. Product-moment partial correlations between the seizure severity scale and QOLIE-89 summary measures ranged from -0.17 to -0.29 (all p values <0.01). Of the seven seizure severity items, the average time before individuals perceived they were "really back to normal" after their seizures was broadly related to all domains of HRQOL (r values ranged from -0.16 to -0.30; p values

Driving in adults with refractory localization-related epilepsy

Abstract: Objective: To examine the frequency of driving an automobile and characteristics associated with driving in individuals with refractory localization-related epilepsy. Background: Driving is generally restricted and monitored in people with epilepsy. Little is known about the frequency of driving and subsequent accidents specifically in individuals with uncontrolled epilepsy. Methods: In an ongoing, prospective, multicenter study of resective epilepsy surgery, individuals were interviewed when they presented for surgical evaluation. Analyses were conducted using chi-square, t-tests, and multiple logistic regression. Results: Of 367 eligible participants, 115 (31.3%) had driven in the last year, most on at least a weekly basis. In a multivariable analysis, factors associated with an increased likelihood of driving were having a current license (OR = 10.71, p Conclusions: Despite restrictions, almost one third of individuals with refractory epilepsy drive. Understanding why they do may help identify means of modifying this behavior or identifying services that, if provided, would help people with uncontrolled epilepsy forego driving.

Cost evaluations in epilepsy: an update.

Abstract: The purpose of this article is to describe the developments in the methodology of studies of the cost of epilepsy and cost-effectiveness of treatments in light of previous reviews and recently published methodological guidelines. Several recent studies are compared, with recently published guidelines by the US Public Health Service (PHS) serving as a framework for discussing selected methodological issues. Results show that these recent studies have made important gains in the quality of cost data obtained, with advances being made by studies that base cost estimates on actual patient data from representative samples as opposed to secondary sources and expert opinions. However, a wide variety of methods continue to be used for many aspects of study design and reporting. Method heterogeneity remains an obstacle to presenting and interpreting reliable and valid information on costs and cost-effectiveness. Areas in need of additional development are methods for estimating direct nonmedical costs, attributing costs to epilepsy versus comorbid conditions, validating health state valuation methods for this population, and validating current recommendations for capturing the costs of lost productivity due to epilepsy. PHS panel recommendations provide a useful framework for working toward consistency in the methods for economic studies in epilepsy.