Prevalence and Incidence of Epilepsy in Italy Based on a Nationwide Database

Giussani, Giorgia; Cricelli, Claudio; Mazzoleni, Francesco; Cricelli, Iacopo; Pasqua, Alessandro; Pecchioli, Serena; Lapi, Francesco; Beghi, Ettore

doi:10.1159/000368801

Cited by 47 publications

(38 citation statements)

References 26 publications

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“…Thus, considering the methodological quality of all 167 studies, a higher quality was observed in HICs compared to LMICs (mean study quality 3.7 vs 3.0, respectively). The largest source of articles originated from HICs (83), followed by MICs (69) and LICs (15). This confirmed the publication bias we expected based on regional research infrastructure disparities.…”

Section: Literature Yieldsupporting

confidence: 79%

An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy

Vaughan

Ramos

Buch

et al. 2019

Journal of Neurosurgery

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OBJECTIVE Epilepsy is one of the most common neurological disorders, yet its global surgical burden has yet to be characterized. The authors sought to compile the most current epidemiological data to quantify global prevalence and incidence, and estimate global surgically treatable epilepsy. Understanding regional and global epilepsy trends and potential surgical volume is crucial for future policy efforts and resource allocation. METHODS The authors performed a systematic literature review and meta-analysis to determine the global incidence, lifetime prevalence, and active prevalence of epilepsy; to estimate surgically treatable epilepsy volume; and to evaluate regional trends by WHO regions and World Bank income levels. Data were extracted from all population-based studies with prespecified methodological quality across all countries and demographics, performed between 1990 and 2016 and indexed on PubMed, EMBASE, and Cochrane. The current and annual new case volumes for surgically treatable epilepsy were derived from global epilepsy prevalence and incidence. RESULTS This systematic review yielded 167 articles, across all WHO regions and income levels. Meta-analysis showed a raw global prevalence of lifetime epilepsy of 1099 per 100,000 people, whereas active epilepsy prevalence is slightly lower at 690 per 100,000 people. Global incidence was found to be 62 cases per 100,000 person-years. The meta-analysis predicted 4.6 million new cases of epilepsy annually worldwide, a prevalence of 51.7 million active epilepsy cases, and 82.3 million people with any lifetime epilepsy diagnosis. Differences across WHO regions and country incomes were significant. The authors estimate that currently 10.1 million patients with epilepsy may be surgical treatment candidates, and 1.4 million new surgically treatable epilepsy cases arise annually. The highest prevalences are found in Africa and Latin America, although the highest incidences are reported in the Middle East and Latin America. These regions are primarily low- and middle-income countries; as expected, the highest disease burden falls disproportionately on regions with the fewest healthcare resources. CONCLUSIONS Understanding of the global epilepsy burden has evolved as more regions have been studied. This up-to-date worldwide analysis provides the first estimate of surgical epilepsy volume and an updated comprehensive overview of current epidemiological trends. The disproportionate burden of epilepsy on low- and middle-income countries will require targeted diagnostic and treatment efforts to reduce the global disparities in care and cost. Quantifying global epilepsy provides the first step toward restructuring the allocation of healthcare resources as part of global healthcare system strengthening.

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Section: Literature Yieldsupporting

confidence: 79%

An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy

Vaughan

Ramos

Buch

et al. 2019

Journal of Neurosurgery

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“…The NIS allowed the normalization of the number of page views according to disease epidemiology, and it was developed as a straightforward tool to evaluate whether online information-seeking for a certain clinical condition reflects its actual prevalence in the general population and identify disparities between health-related informative need and disease burden. The most recent data on the crude prevalence of any of the selected neurological disorders in Italy were retrieved through an extensive search of the literature [3][4][5][6][7]. Lifetime cumulative incidence in a Dutch population was used for syncope [8] since no epidemiological study was available in Italy.…”

Section: Methodsmentioning

confidence: 99%

Italian Wikipedia and epilepsy: An infodemiological study of online information-seeking behavior

Brigo

Lattanzi

Giussani

et al. 2018

Epilepsy & Behavior

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Wikipedia is the most commonly accessed source of health information by both healthcare professionals and the lay public worldwide. We aimed to evaluate information-seeking behavior of Internet users searching the Italian Wikipedia for articles related to epilepsy and its treatment. Using Pageviews Analysis, we assessed the total and mean monthly views of articles from the Italian Wikipedia devoted to epilepsy, epileptic syndromes, seizure type, and antiepileptic drugs (AEDs) from January 1, 2015 to October 31, 2017. We compared the views of the article on epilepsy with those of articles focusing on Alzheimer's disease, migraine, multiple sclerosis, syncope, and stroke and adjusted all results for crude disease prevalence. With the only exception of the article on multiple sclerosis, the adjusted views for the Italian Wikipedia article on epilepsy were higher than those for the other neurological disorders. The most viewed articles on seizure type were devoted to tonic-clonic seizure, typical absence seizure, tonic convulsive seizures, and clonic convulsive seizures. The most frequently accessed articles on epilepsy syndromes were about temporal lobe epilepsy and Lennox-Gastaut syndrome. The most frequently viewed articles on AEDs were devoted to valproic acid, carbamazepine, and levetiracetam. Wikipedia searches seem to mirror patients' fears and worries about epilepsy more than its actual epidemiology. The ultimate reasons for searching online remain unknown. Epileptologists and epilepsy scientific societies should make greater efforts to work jointly with Wikipedia to convey more accurate and up-to-date information about epilepsy.

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“…Data within the HSD is coded using internationally recognized codes such as the Anatomical Therapeutic Chemical (ATC) classification system for drugs and the 9th version of the International Classification of Disease, Clinical Modification (ICD-9-CM) for medical diagnoses. The reliability of HSD for conducting clinical research has been demonstrated elsewhere [40][41][42][43].…”

Section: Data Sourcementioning

confidence: 98%

Drug interactions in users of tablet vs. oral liquid levothyroxine formulations: a real-world evidence study in primary care

et al. 2017

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Purpose Several medications may interact with levothyroxine (LT4) intestinal absorption or metabolism, thus reducing its bioavailability. We investigated the variability of thyroid stimulating hormone (TSH) levels and prescribed daily dosages (PDDs) of LT4 before and during potential drug-drug interactions (DDIs) in users of tablets vs. oral liquid LT4 formulations. Methods By using the Italian general practice Health Search Database (HSD), we retrospectively selected adult patients with at least one LT4 prescription from 2012 to 2015 and at least 1 year of clinical history recorded. The incident prescription of interacting medications (e.g., proton pump inhibitors, calcium or iron salts) was the index date. Analysis was carried out using a self-controlled study design. Results Overall, 3965 users of LT4 formed the study cohort (84.1% women, mean age 56 ± 16.5 years). TSH variability on the entry date was greater among liquid LT4 users than in those prescribed with tablets as shown by the difference between 75th and 25th centile, which were 3.01 and 3.8, respectively. The incidence rate ratio (IRR) for TSH variability did not differ between groups, before and during exposure to DDIs. In contrast, PDDs less likely increased during the exposure to DDI with oral liquid LT4 compared with tablets (IRR = 0.84; 95% CI: 0.77-0.92), especially in patients with post-surgical hypothyroidism (IRR = 0.75; 95% CI: 0.64-0.85). Conclusions In clinical practice, the use of oral liquid LT4 is not associated with increased PDDs, compared with tablets formulation, during exposure to DDIs. These results support the need for individualizing LT4 formulation to prescribe, especially in patients with various comorbidities and complex therapeutic regimens.

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Prevalence and Incidence of Epilepsy in Italy Based on a Nationwide Database

Cited by 47 publications

References 26 publications

An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy

An estimation of global volume of surgically treatable epilepsy based on a systematic review and meta-analysis of epilepsy

Italian Wikipedia and epilepsy: An infodemiological study of online information-seeking behavior

Drug interactions in users of tablet vs. oral liquid levothyroxine formulations: a real-world evidence study in primary care

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