Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in a series of 76 patients

Durnford, Andrew J., Rodgers, William, Kirkham, Fenella J., Mullee, Mark A., Whitney, Andrea, Prevett, Martin, Kinton, Lucy, Harris, Matthew and Gray, William P. (2011) Very good inter-rater reliability of Engel and ILAE epilepsy surgery outcome classifications in a series of 76 patients. Seizure, 20 (10), 809-812. (doi:10.1016/j.seizure.2011.08.004).

Abstract

The inter-rater reliability, expressed as kappa score, k, of the Engel and International League Against Epilepsy (ILAE) classifications of epilepsy surgery seizure outcome has not previously been evaluated. In a consecutive series of 76 patients (40 male; 25 children), 75 undergoing resective and 1 disconnective surgery at a mean age of 27.5 years (13 months-62 years), one observer classified 88% (n = 67) and a second observer classified 87% (n = 66) of patients as either Engel I or II (free from or rare disabling seizures) after a median follow up of 36 months (range 12-92 months); comparably, both observers classified 84% (n = 64) as ILAE 1-3. Correlation for Engel versus ILAE for observer 1 was 0.933 (p <.0005) and for observer 2 was 0.931 (p <.0005). Both ILAE (k 0.81, 95% confidence intervals 0.69, 0.91) and Engel (k 0.77, 95% CI 0.65, 0.87) classifications have very acceptable inter-rater reliability as well as significant correlation.

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Contributors

Author: Fenella J. Kirkham

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