Diagnoses, procedures, drug utilization, comorbidities, and cost of health care for people with epilepsy in 2012

Wilner, Andrew N.; Sharma, Bal Krishan; Thompson, Andrew R.; Soucy, Alison; Krueger, Andrew

doi:10.1016/j.yebeh.2014.08.131

Cited by 33 publications

(45 citation statements)

References 25 publications

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“…Thirteen studies identified cases based on AED use (studies 3–12, 15, 16, and 18) . Eight studies included both active and inactive epilepsy cases (1, 2, 13, 14, 17, and 21–23) …”

Section: Resultsmentioning

confidence: 99%

The direct cost of epilepsy in the United States: A systematic review of estimates

Begley¹,

Durgin²

2015

Epilepsia

221

144

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SUMMARYObjective: To develop estimates of the direct cost of epilepsy in the United States for the general epilepsy population and sub-populations by systematically comparing similarities and differences in types of estimates and estimation methods from recently published studies. Methods: Papers published since 1995 were identified by systematic literature search. Information on types of estimates, study designs, data sources, types of epilepsy, and estimation methods was extracted from each study. Annual per person cost estimates from methodologically similar studies were identified, converted to 2013 U.S. dollars, and compared. Results: From 4,104 publications discovered in the literature search, 21 were selected for review. Three were added that were published after the search. Eighteen were identified that reported estimates of average annual direct costs for the general epilepsy population in the United States. For general epilepsy populations (comprising all clinically defined subgroups), total direct healthcare costs per person ranged from $10,192 to $47,862 and epilepsy-specific costs ranged from $1,022 to $19,749. Four recent studies using claims data from large general populations yielded relatively similar epilepsy-specific annual cost estimates ranging from $8,412 to $11,354. Although more difficult to compare, studies examining direct cost differences for epilepsy sub-populations indicated a consistent pattern of markedly higher costs for those with uncontrolled or refractory epilepsy, and for those with comorbidities. Significance: This systematic review found that various approaches have been used to estimate the direct costs of epilepsy in the United States. However, recent studies using large claims databases and similar methods allow estimation of the direct cost burden of epilepsy for the general disease population, and show that it is greater for some patient subgroups. Additional research is needed to further understand the broader economic burden of epilepsy and how it varies across subpopulations.

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“…Thirteen studies identified cases based on AED use (studies 3–12, 15, 16, and 18) . Eight studies included both active and inactive epilepsy cases (1, 2, 13, 14, 17, and 21–23) …”

Section: Resultsmentioning

confidence: 99%

The direct cost of epilepsy in the United States: A systematic review of estimates

Begley¹,

Durgin²

2015

Epilepsia

221

144

View full text Add to dashboard Cite

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“…Brain MRI is a highly sensitive method for detection of structural changes. As compared to brain CT, MRI is much more accurate for detecting structural brain changes in patients with epilepsy (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…Its superiority compared with computerized tomography was immediately recognizedafter its development. First generation computed tomography reveals only 3% of operable lesions (6). MRI, however, detects up to 80% of operable temporal lesions in patients who can benefit from a temporal lobotomy and up to 60% of frontal lesions in patients that can benefit from surgery of the frontal lobes (7,8 International League Against Epilepsy recommends performing an MRI in all patients with epilepsy, except for those with idiopathic generalized epilepsy (9).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

Dakaj¹,

Kruja²,

Jashari³

et al. 2016

Acta Inform Med

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

et al. 2016

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Background:Epilepsy is a neurological disorder characterized by abnormal firing of nerve impulses in the brain.Aim:This study aims to investigate the frequency of appearance of pathological changes in conventional examination methods (electroencephalography–EEG, brain computerized tomography -CT or brain magnetic resonance imaging – MRI) in patients with epilepsy, and relationship between clinical manifestations and localization of changes in CT or MRI.Methods:In this study we have included 110 patients with focal epilepsy who fulfilled the inclusion criteria out of 557 initially diagnosed patients. Detailed clinical examination together with brain imaging (CT and MRI) and electroencephalography examination was performed. We have evaluated the accuracy of each diagnostic method to localize the epileptic focus. Diagnosis of epilepsy was determined by the ILAE (International League Against Epilepsy) criteria of the year 1989, and classification of epileptic seizures was made according to the ILAE classification 2010.Results:Electroencephalography presented changes in 60.9% of patients; brain CT in 42.1%, and MRI in 78% of the patients. The results of our study showed that clinical manifestations were not always conveyed with pathological changes in conventional examining methods performed. Of the total of 79 patients with changes in imaging (8 with changes in CT and 71 in MRI), 79.7% presented a clinical picture compatible with the region in which morphological changes were found, while in 20.3% of patients the presented morphological changes were not aligned with the clinical picture.Conclusion:In patients with epilepsy, conventional examination methods do not always find pathological changes, while clinical manifestations of epilepsy did not always coincide with the location of changes in imaging. Further studies are needed to see if there is clear border between focal and generalized epilepsy.

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Diagnoses, procedures, drug utilization, comorbidities, and cost of health care for people with epilepsy in 2012

Cited by 33 publications

References 25 publications

The direct cost of epilepsy in the United States: A systematic review of estimates

The direct cost of epilepsy in the United States: A systematic review of estimates

Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

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