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people with epilepsy" /></a></div><div class="bkr_bib"><h1 id="_NBK581147_"><span itemprop="name">Evidence review: Prediction of death, including SUDEP, in people with epilepsy</span></h1><div class="subtitle">Epilepsies in children, young people and adults: diagnosis and management</div><p><b>Evidence review 17</b></p><p><i>NICE Guideline, No. 217</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2022 Apr</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-4513-9</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div></div><div class="bkr_clear"></div></div><div id="niceng217er17.s1"><h2 id="_niceng217er17_s1_">1. Prediction of death, including SUDEP, in people with epilepsy</h2><div id="niceng217er17.s1.1"><h3>1.1. Review question</h3><p>What are the most accurate tools to predicting death, including SUDEP, in people with epilepsy?</p><div id="niceng217er17.s1.1.1"><h4>1.1.1. Introduction</h4><p>Epilepsy is associated with risks of premature morbidity and mortality from a number of causes. These include a risk of injury, including head injury, and mortality in the form of drowning and accidents. One cause of epilepsy-related mortality is Sudden Unexpected Death in Epilepsy (SUDEP). Overall, the rate of SUDEP is around 1 in 1000 people with epilepsy per year.</p><p>Prediction of which people are most at risk of these adverse outcomes would allow health care practitioners to work together with people with epilepsy, particularly those identified to be at higher risk of mortality, and better target education and management options on an individualised basis.</p></div><div id="niceng217er17.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><p>For full details see the review protocol in <a href="#niceng217er17.appa">Appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab1"><a href="/books/NBK581147/table/niceng217er17.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab1" rid-ob="figobniceng217er17tab1"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab1/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab1"><a href="/books/NBK581147/table/niceng217er17.tab1/?report=objectonly" target="object" rid-ob="figobniceng217er17tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="niceng217er17.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng217er17.appa">appendix A</a> and the methods document.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng217er17.s1.1.4"><h4>1.1.4. Predictive evidence</h4><div id="niceng217er17.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><p>A search was made for studies that measure the accuracy of tools for predicting SUDEP/death from any cause. Three prediction tool studies were included in the review.<a class="bibr" href="#niceng217er17.ref4" rid="niceng217er17.ref4"><sup>4</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng217er17.ref12" rid="niceng217er17.ref12"><sup>12</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng217er17.ref19" rid="niceng217er17.ref19"><sup>19</sup></a> The key characteristics of these studies are summarised in <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab2/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab2" rid-ob="figobniceng217er17tab2">Table 2</a> below, while <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3">Table 3</a> summarises the predictions tools used in the studies. Evidence from these studies is summarised in the clinical evidence summary below in <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab4/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab4" rid-ob="figobniceng217er17tab4">Table 4</a> to <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab7/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab7" rid-ob="figobniceng217er17tab7">Table 7</a>.</p><p>Stratification of studies was planned for age (<18/≥18), follow up time (<1 yr., 1–5 yrs., >5 yrs.), and whether the event outcome was specifically SUDEP or all-cause mortality (which could include SUDEP). Because there was >1 stratification strategy, studies were analysed in emergent strata that were permutations of the stratification categories. The two strata that emerged were:
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<ul><li class="half_rhythm"><div>Adult/unclear follow up time/SUDEP</div></li><li class="half_rhythm"><div>Mixed age group/>5 years follow up/ all-cause mortality</div></li></ul></p><p>Within each stratum, sub-grouping had been planned to try to ‘explain’ heterogeneity in meta-analyses according to the following strategies: Young subgroups: <2, 2–11, 11–18; Adults: 18–55, >55; Learning disability vs no learning disability; Head injury vs no head injury; Type of epilepsy; gender. However, these sub-grouping strategies were not required because in the absence of pooled data, no heterogeneity existed.</p><p>The assessment of the evidence quality was conducted with emphasis on discrimination measures such as sensitivity/specificity and the C statistic, as these were identified by the committee as the primary measures in guiding decision-making. The committee set clinical decision thresholds for
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<ul><li class="half_rhythm"><div>Sensitivity: 0.9 above which a test would be recommended and 0.6 below which a test is of no clinical use.</div></li><li class="half_rhythm"><div>Specificity: 0.5 above which a test would be recommended and 0.1 below which a test is of no clinical use.</div></li><li class="half_rhythm"><div>C statistics: 0.7 above which a test would be recommended and 0.5 below which a test is of no clinical use.</div></li></ul></p><p>See also the study selection flow chart in <a href="#niceng217er17.appc">Appendix C</a>, and study evidence tables in <a href="#niceng217er17.appd">Appendix D</a>.</p></div><div id="niceng217er17.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>See the excluded studies list in <a href="#niceng217er17.appj">Appendix J</a>.</p></div></div><div id="niceng217er17.s1.1.5"><h4>1.1.5. Summary of studies included in the predictive evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab2"><a href="/books/NBK581147/table/niceng217er17.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab2" rid-ob="figobniceng217er17tab2"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab2/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab2"><a href="/books/NBK581147/table/niceng217er17.tab2/?report=objectonly" target="object" rid-ob="figobniceng217er17tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab3"><a href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab3/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab3/?report=previmg" alt="Table 3. Summary of prediction tools used in the included studies and constituent variables and cut-offs (where available)." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab3"><a href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-ob="figobniceng217er17tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of prediction tools used in the included studies and constituent variables and cut-offs (where available). </p></div></div><p>See <a href="#niceng217er17.appd">Appendix D</a> for full evidence tables</p></div><div id="niceng217er17.s1.1.6"><h4>1.1.6. Summary of the predictive evidence</h4><div id="niceng217er17.s1.1.6.1"><h5>1.1.6.1. Adult/unclear follow up/SUDEP stratum</h5><p>The evidence for this section was derived from two studies<a class="bibr" href="#niceng217er17.ref4" rid="niceng217er17.ref4"><sup>4</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng217er17.ref19" rid="niceng217er17.ref19"><sup>19</sup></a> that did not directly present data on the predictive accuracy of the evaluated tools. However, both studies presented the scores of those who developed SUDEP during follow up, as well as the scores of those that did not develop SUDEP during follow up, which allowed the reviewer to calculate sensitivities and specificities at each threshold of the score. For each threshold of score (starting from ≥1 up to ≥9), 2×2 tables were created. 2×2 table cells for true positives (those who developed SUDEP with a score at or above the threshold), false negatives (those who developed SUDEP with a score below the threshold), false positives (those who did not develop SUDEP with a score at or above the threshold), and true negatives (those who did not develop SUDEP with a score below the threshold) were then populated. This permitted sensitivity and specificity data at each threshold to be calculated (albeit with high uncertainty for sensitivity because of the small sample sizes), but the ROC curves produced only permitted an estimation of the area under the curve (C statistics).</p></div><div id="niceng217er17.s1.1.6.2"><h5>1.1.6.2. Discrimination</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab4"><a href="/books/NBK581147/table/niceng217er17.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab4" rid-ob="figobniceng217er17tab4"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab4/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab4/?report=previmg" alt="Table 4. Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see Table 3)." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab4"><a href="/books/NBK581147/table/niceng217er17.tab4/?report=objectonly" target="object" rid-ob="figobniceng217er17tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see Table 3). </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab5"><a href="/books/NBK581147/table/niceng217er17.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab5" rid-ob="figobniceng217er17tab5"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab5/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab5/?report=previmg" alt="Table 5. Clinical evidence profile: sensitivity and specificity of prediction tools featured in the studies (see Table 3)." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab5"><a href="/books/NBK581147/table/niceng217er17.tab5/?report=objectonly" target="object" rid-ob="figobniceng217er17tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Clinical evidence profile: sensitivity and specificity of prediction tools featured in the studies (see Table 3). </p></div></div><div id="niceng217er17.s1.1.6.2.1"><h5>1.1.6.2.1. Mixed age, >5 yr. follow up, All-cause mortality stratum</h5><div id="niceng217er17.s1.1.6.2.1.1"><h5>Discrimination</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab6"><a href="/books/NBK581147/table/niceng217er17.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab6" rid-ob="figobniceng217er17tab6"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab6/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab6/?report=previmg" alt="Table 6. Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see table 3)." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab6"><a href="/books/NBK581147/table/niceng217er17.tab6/?report=objectonly" target="object" rid-ob="figobniceng217er17tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see table 3). </p></div></div></div><div id="niceng217er17.s1.1.6.2.1.2"><h5>Calibration</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng217er17tab7"><a href="/books/NBK581147/table/niceng217er17.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng217er17tab7" rid-ob="figobniceng217er17tab7"><img class="small-thumb" src="/books/NBK581147/table/niceng217er17.tab7/?report=thumb" src-large="/books/NBK581147/table/niceng217er17.tab7/?report=previmg" alt="Table 7. Clinical evidence profile: Calibration (goodness of fit) (Schoenfeld p value) of prediction tools featured in the studies (see table 3)." /></a><div class="icnblk_cntnt"><h4 id="niceng217er17.tab7"><a href="/books/NBK581147/table/niceng217er17.tab7/?report=objectonly" target="object" rid-ob="figobniceng217er17tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Clinical evidence profile: Calibration (goodness of fit) (Schoenfeld p value) of prediction tools featured in the studies (see table 3). </p></div></div><p>See details of predictive evidence in <a href="#niceng217er17.appd">Appendix D</a>.</p></div></div></div></div><div id="niceng217er17.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng217er17.s1.1.7.1"><h5>1.1.7.1. Included studies</h5><p>No health economic studies were included.</p></div><div id="niceng217er17.s1.1.7.2"><h5>1.1.7.2. Excluded studies</h5><p>No relevant health economic studies were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#niceng217er17.appg">Appendix G</a>.</p></div></div><div id="niceng217er17.s1.1.8"><h4>1.1.8. Economic model</h4><p>This area was not prioritised for a new cost-effectiveness analysis.</p></div><div id="niceng217er17.s1.1.9"><h4>1.1.9. Evidence statements</h4><div id="niceng217er17.s1.1.9.1"><h5>1.1.9.1. Clinical evidence statements</h5><ul><li class="half_rhythm"><div>None.</div></li></ul></div><div id="niceng217er17.s1.1.9.2"><h5>1.1.9.2. Economic</h5><ul><li class="half_rhythm"><div>No relevant economic evaluations were identified.</div></li></ul></div></div><div id="niceng217er17.s1.1.10"><h4>1.1.10. The committee’s discussion and interpretation of the evidence</h4><div id="niceng217er17.s1.1.10.1"><h5>1.1.10.1. The outcomes that matter most</h5><p>During protocol development, sensitivity and specificity of the prediction tool were agreed to be critical outcomes. Sensitivity is critical because it is vital to know how many people that go on to have SUDEP or die from other causes will be incorrectly labelled as low risk by the prediction tool (the higher the number of such false negatives, the lower the sensitivity). Specificity is also critical because it is important to know how many people who do not go on to have SUDEP or die from other causes will be mistakenly labelled as high risk by the prediction tool (the higher the number of such false positives, the lower the specificity). Knowledge of the likelihood of false negatives and false positives is essential so that clinicians can use tools where 1) patients at high risk will not be missed, and 2) patients at low risk will not be given inappropriately high levels of surveillance and anxiety. Sensitivity was deemed to be more important than specificity because the harms resulting from false negatives are worse than the harms resulting from false positives in the context of SUDEP/all-cause mortality prediction. This is because a false negative result could lead to patients who require preventative measures not receiving the care that they need, which may cause harm. In contrast, a false positive result may lead to increased costs and anxiety but is unlikely to lead to physically dangerous sequelae. However, specificity still needs to be high enough to correctly identify a reasonable proportion of those not requiring preventative measures as the use of a tool with 100% sensitivity with very poor specificity provides little advantage over not using a prediction tool at all because it will label most patients at high risk even when they are not.</p><p>C statistics were regarded as less important by the committee because they do not differentiate between sensitivity and specificity (from which they are derived) even though sensitivity may be more important in this context.</p><p>Calibration statistics were regarded as of equal status to sensitivity, as they allow an accurate evaluation of the agreement between the absolute risks yielded by the tools and the observed risks at all levels of risk; accurate risk evaluation may be of great importance when discussing results with the patient.</p></div><div id="niceng217er17.s1.1.10.2"><h5>1.1.10.2. The quality of the evidence</h5><p>The evidence examining SUDEP risk tool scores was graded low or very low. This was due to methodological limitations such as a lack of blinding and also the very high imprecision in sensitivity measures due to the small number of outcome events. The evidence looking at tools for all-cause mortality was moderate to high, as the methodology was more rigorous. However, measures of imprecision were not provided.</p></div><div id="niceng217er17.s1.1.10.3"><h5>1.1.10.3. Benefits and harms</h5><p>The data on the predictive accuracy of the SUDEP-7 and SUDEP-7 revised tools suggested a very high sensitivity (1.0) and specificity (0.91) at a threshold of ≥7 for SUDEP 7 and a high sensitivity (1.0) and moderate specificity (0.48) at a threshold of ≥4 for the revised version. If sensitivities and specificities are above 0.9, a tool would normally be considered potentially useful. However, the very wide confidence intervals for sensitivity due to the small number of SUDEP events made these results largely meaningless, as they suggested that in the population, the sensitivity could plausibly lie anywhere between 0.025 to 1.0. The C statistics results showed a similarly encouraging point estimate, but again the confidence intervals (although not calculable) would have been too wide to enable any useful conclusions. Therefore, the committee concluded that there was inadequate evidence to recommend SUDEP prediction tools.</p><p>For all-cause mortality prediction, three tools were found with excellent Harrel’s C statistics. No confidence intervals were provided, but given the large sample size of >500, it is highly likely that these estimates were precise. However, calibration evidence was poorly reported, with no clear measure of effect and only a p-value showing that the calibration was not entirely due to sampling error. Overall, the committee did not think that the evidence provided enough useful data to allow any recommendation for all-cause mortality tools.</p><p>The committee, therefore, agreed that a recommendation was not possible for the use of any particular SUDEP or all-cause mortality prediction tools. The committee discussed whether it is appropriate to have risk prediction tools for SUDEP or all-cause death. The committee considered that a tool, even if accurate on a population level, may give erroneous results for some individuals, with the attendant harms. The determination of a high risk is frightening to the patient and may cause significant adverse psychological effects. The committee agreed that medical care should focus on assuming that all people are at risk of death and that the main attention should be on identifying and modifying risk factors, stopping all seizures and discussing this with the individual with epilepsy and their family and carers. Nevertheless, risk tools were acknowledged to have a potential important role, as there is often a need to prioritise those people at highest risk and ensure they get urgent and proactive care. There are insufficient resources to assume all people are at high risk and it may be important to yield higher scores to prompt more urgent action. The example was given of a patient who might intuitively be regarded as of low risk by a non-epilepsy clinician but who might yield a high score demonstrating a real risk. This might precipitate preventative action that might not otherwise be taken.</p><p>When developing a research recommendation, the committee agreed that a tool should not focus entirely on SUDEP and should look at all causes of mortality, because there are other causes of death in epilepsy such as suicide, injury, or drowning.</p><p>The committee agreed any new tools would require development from very large databases. Large national or international registries, recording SUDEP, all causes of death and a wide range of plausible risk factors would be necessary in order to produce data of sufficient detail to inform a useful tool. These would ideally need to collect data over a long period in order to collect useful numbers of outcomes. These developmental databases could then be used to create new algorithms, which could be validated in large external datasets.</p><p>In addition, the committee was aware that the SUDEP-7 tool showed some promise, despite the uncertainties in the data, and also agreed that further larger-scale validation studies of SUDEP-7 should be conducted in the shorter term.</p></div></div><div id="niceng217er17.s1.1.11"><h4>1.1.11. Cost effectiveness and resource use</h4><p>No economic evidence was identified for this review.</p><p>The committee concluded they were unable to make a recommendation based on the clinical evidence presented. Subsequently, the committee made a research recommendation for a risk prediction tool to be developed.</p></div><div id="niceng217er17.s1.1.12"><h4>1.1.12. Other factors the committee took into account</h4><p>None.</p></div><div id="niceng217er17.s1.1.13"><h4>1.1.13. Recommendations supported by this evidence review</h4><p>This evidence review supports the research recommendations on:
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<ul><li class="half_rhythm"><div>identifying and mitigating SUDEP risk factors,</div></li><li class="half_rhythm"><div>developing a risk prediction tool to detect all-cause mortality (including SUDEP)</div></li><li class="half_rhythm"><div>creating a validation of a risk prediction tool to detect the probability of epilepsy-related death in people with epilepsy.</div></li></ul></p><p>No recommendations were made from this evidence review.</p></div></div></div><div id="niceng217er17.rl.r1"><h2 id="_niceng217er17_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng217er17.ref1">Annegers
|
|
JF, Coan
|
|
SP, Hauser
|
|
WA, Leestma
|
|
J. Epilepsy, vagal nerve stimulation by the NCP system, all-cause mortality, and sudden, unexpected, unexplained death. Epilepsia. 2000; 41(5):549–553 [<a href="https://pubmed.ncbi.nlm.nih.gov/10802760" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10802760</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="niceng217er17.ref2">Antoniuk
|
|
SA, Oliva
|
|
LV, Bruck
|
|
I, Malucelli
|
|
M, Yabumoto
|
|
S, Castellano
|
|
JL. Sudden unexpected, unexplained death in epilepsy autopsied patients. Arquivos de Neuro-Psiquiatria. 2001; 59(1):40–45 [<a href="https://pubmed.ncbi.nlm.nih.gov/11299429" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11299429</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="niceng217er17.ref3">Arora
|
|
NA, Cheng
|
|
J. Correlation of APACHE II score in status epilepticus with mortality: A retrospective analysis. Neurocritical Care. 2015; 23(Suppl 1):S18</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="niceng217er17.ref4">Baysal-Kirac
|
|
L, Serbest
|
|
NG, Sahin
|
|
E, Dede
|
|
HO, Gurses
|
|
C, Gokyigit
|
|
A
|
|
et al
|
|
Analysis of heart rate variability and risk factors for SUDEP in patients with drug-resistant epilepsy. Epilepsy & Behavior. 2017; 71(Pt A):60–64 [<a href="https://pubmed.ncbi.nlm.nih.gov/28549245" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28549245</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="niceng217er17.ref5">Brown
|
|
S, Shankar
|
|
R, Cox
|
|
D, McLean
|
|
BM, Jory
|
|
C. Clinical governance: risk assessment in SUDEP. Clinical Governance. 2013; 18(4):325–331</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="niceng217er17.ref6">Chen
|
|
RC, Chang
|
|
YC, Chen
|
|
TH, Wu
|
|
HM, Liou
|
|
HH. Mortality in adult patients with epilepsy in Taiwan. Epileptic Disorders. 2005; 7(3):213–219 [<a href="https://pubmed.ncbi.nlm.nih.gov/16162430" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16162430</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="niceng217er17.ref7">DeGiorgio
|
|
CM, Miller
|
|
P, Meymandi
|
|
S, Chin
|
|
A, Epps
|
|
J, Gordon
|
|
S
|
|
et al
|
|
RMSSD, a measure of vagus-mediated heart rate variability, is associated with risk factors for SUDEP: the SUDEP-7 Inventory. Epilepsy & Behavior. 2010; 19(1):78–81 [<a href="/pmc/articles/PMC2943000/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2943000</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20667792" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20667792</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="niceng217er17.ref8">Ficker
|
|
DM, So
|
|
EL, Shen
|
|
WK, Annegers
|
|
JF, O’Brien
|
|
PC, Cascino
|
|
GD
|
|
et al
|
|
Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology. 1998; 51(5):1270–1274 [<a href="https://pubmed.ncbi.nlm.nih.gov/9818844" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9818844</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="niceng217er17.ref9">Hirdes
|
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JP, Poss
|
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JW, Mitchell
|
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L, Korngut
|
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L, Heckman
|
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G. Use of the interRAI CHESS Scale to predict mortality among persons with neurological conditions in three care settings. PloS One. 2014; 9(6):e99066 [<a href="/pmc/articles/PMC4051671/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4051671</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24914546" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24914546</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="niceng217er17.ref10">Hitiris
|
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N, Suratman
|
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S, Kelly
|
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K, Stephen
|
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LJ, Sills
|
|
GJ, Brodie
|
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MJ. Sudden unexpected death in epilepsy: a search for risk factors. Epilepsy & Behavior. 2007; 10(1):138–141 [<a href="https://pubmed.ncbi.nlm.nih.gov/17196884" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17196884</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="niceng217er17.ref11">Hughes
|
|
JR. A review of sudden unexpected death in epilepsy: Prediction of patients at risk. Epilepsy & Behavior. 2009; 14(2):280–287 [<a href="https://pubmed.ncbi.nlm.nih.gov/19130900" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19130900</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="niceng217er17.ref12">Keezer
|
|
MR, Bell
|
|
GS, Jette
|
|
N, Sander
|
|
JW. The performance of three mortality risk-adjustment comorbidity indices in a community epilepsy cohort. Epilepsia. 2015; 56(5):e68–72 [<a href="https://pubmed.ncbi.nlm.nih.gov/25845308" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25845308</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="niceng217er17.ref13">Langan
|
|
Y, Nashef
|
|
L, Sander
|
|
JW. Case-control study of SUDEP. Neurology. 2005; 64(7):1131–1133 [<a href="https://pubmed.ncbi.nlm.nih.gov/15824334" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15824334</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="niceng217er17.ref14">Langan
|
|
Y, Nolan
|
|
N, Hutchinson
|
|
M. The incidence of sudden unexpected death in epilepsy (SUDEP) in South Dublin and Wicklow. Seizure. 1998; 7(5):355–358 [<a href="https://pubmed.ncbi.nlm.nih.gov/9808109" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9808109</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="niceng217er17.ref15">Lear-Kaul
|
|
KC, Coughlin
|
|
L, Dobersen
|
|
MJ. Sudden unexpected death in epilepsy: a retrospective study. American Journal of Forensic Medicine and Pathology. 2005; 26(1):11–17 [<a href="https://pubmed.ncbi.nlm.nih.gov/15725771" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15725771</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="niceng217er17.ref16">Monte
|
|
CPJA, Arends
|
|
JBAM, Tan
|
|
IY, Aldenkamp
|
|
AP, Limburg
|
|
M, de Krom
|
|
MCTFM. Sudden unexpected death in epilepsy patients: Risk factors. A systematic review. Seizure. 2007; 16(1):1–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/17134918" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17134918</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="niceng217er17.ref17">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [updated October 2020]. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a></div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="niceng217er17.ref18">Nilsson
|
|
L, Farahmand
|
|
BY, Persson
|
|
PG, Thiblin
|
|
I, Tomson
|
|
T. Risk factors for sudden unexpected death in epilepsy: a case-control study. Lancet. 1999; 353(9156):888–893 [<a href="https://pubmed.ncbi.nlm.nih.gov/10093982" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10093982</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="niceng217er17.ref19">Novak
|
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JL, Miller
|
|
PR, Markovic
|
|
D, Meymandi
|
|
SK, DeGiorgio
|
|
CM. Risk assessment for sudden death in epilepsy: The SUDEP-7 Inventory. Frontiers in Neurology. 2015; 6:252 [<a href="/pmc/articles/PMC4673971/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4673971</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26696953" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26696953</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="niceng217er17.ref20">Odom
|
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N, Bateman
|
|
LM. Sudden unexpected death in epilepsy, periictal physiology, and the SUDEP-7 Inventory. Epilepsia. 2018; 59(10):e157–e160 [<a href="/pmc/articles/PMC6204287/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6204287</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30159901" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30159901</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="niceng217er17.ref21">Ridsdale
|
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L, Charlton
|
|
J, Ashworth
|
|
M, Richardson
|
|
MP, Gulliford
|
|
MC. Epilepsy mortality and risk factors for death in epilepsy: a population-based study. British Journal of General Practice. 2011; 61(586):e271–278 [<a href="/pmc/articles/PMC3080232/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3080232</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21619751" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21619751</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="niceng217er17.ref22">Salmo
|
|
EN, Connolly
|
|
CE. Mortality in epilepsy in the west of Ireland: a 10-year review. Irish Journal of Medical Science. 2002; 171(4):199–201 [<a href="https://pubmed.ncbi.nlm.nih.gov/12647908" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12647908</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="niceng217er17.ref23">Shankar
|
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R, Ashby
|
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S, McLean
|
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B, Newman
|
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C. Bridging the gap of risk communication and management using the SUDEP and Seizure Safety Checklist. Epilepsy & Behavior. 2020; 103(Pt B):106419 [<a href="https://pubmed.ncbi.nlm.nih.gov/31648927" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31648927</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="niceng217er17.ref24">Shankar
|
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R, Cox
|
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D, Jalihal
|
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V, Brown
|
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S, Hanna
|
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J, McLean
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B. Sudden unexpected death in epilepsy (SUDEP): development of a safety checklist. Seizure. 2013; 22(10):812–817 [<a href="https://pubmed.ncbi.nlm.nih.gov/23962523" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23962523</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="niceng217er17.ref25">Shankar
|
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R, Hanna
|
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J, McLean
|
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B, Cox
|
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D, Jory
|
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C, Newman
|
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C
|
|
et al
|
|
The sudep safety checklist list project: Steps towards self-management of sudep risk for patients with epilepsy (PWE). Epilepsia. 2015; 56(S1):38–39</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="niceng217er17.ref26">Shankar
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R, Henley
|
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W, Boland
|
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C, Laugharne
|
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R, McLean
|
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BN, Newman
|
|
C
|
|
et al
|
|
Decreasing the risk of sudden unexpected death in epilepsy: structured communication of risk factors for premature mortality in people with epilepsy. European Journal of Neurology. 2018; 25(9):1121–1127 [<a href="https://pubmed.ncbi.nlm.nih.gov/29611888" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29611888</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="niceng217er17.ref27">Shankar
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R, Newman
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C, Gales
|
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A, McLean
|
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BN, Hanna
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J, Ashby
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S
|
|
et al
|
|
Has the Time Come to Stratify and Score SUDEP Risk to Inform People With Epilepsy of Their Changes in Safety?
|
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Frontiers in Neurology. 2018; 9:281 [<a href="/pmc/articles/PMC5934492/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5934492</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29755403" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29755403</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="niceng217er17.ref28">Shankar
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R, Walker
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M, McLean
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B, Laugharne
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R, Ferrand
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F, Hanna
|
|
J
|
|
et al
|
|
Steps to prevent SUDEP: the validity of risk factors in the SUDEP and seizure safety checklist: a case control study. Journal of Neurology. 2016; 263(9):1840–1846 [<a href="https://pubmed.ncbi.nlm.nih.gov/27334909" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27334909</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="niceng217er17.ref29">Sun
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JJ, Perera
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B, Henley
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W, Ashby
|
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S, Shankar
|
|
R. Seizure and Sudden Unexpected Death in Epilepsy (SUDEP) characteristics in an urban UK intellectual disability service. Seizure. 2020; 80:18–23 [<a href="https://pubmed.ncbi.nlm.nih.gov/32485614" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32485614</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="niceng217er17.ref30">Tennis
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P, Cole
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TB, Annegers
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JF, Leestma
|
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JE, McNutt
|
|
M, Rajput
|
|
A. Cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada. Epilepsia. 1995; 36(1):29–36 [<a href="https://pubmed.ncbi.nlm.nih.gov/8001505" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8001505</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="niceng217er17.ref31">Walczak
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TS, Leppik
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IE, D’Amelio
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M, Rarick
|
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J, So
|
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E, Ahman
|
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P
|
|
et al
|
|
Incidence and risk factors in sudden unexpected death in epilepsy: a prospective cohort study. Neurology. 2001; 56(4):519–525 [<a href="https://pubmed.ncbi.nlm.nih.gov/11222798" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11222798</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="niceng217er17.ref32">Wandschneider
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B, Koepp
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M, Scott
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C, Micallef
|
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C, Balestrini
|
|
S, Sisodiya
|
|
SM
|
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et al
|
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Structural imaging biomarkers of sudden unexpected death in epilepsy. Brain. 2015; 138(Pt 10):2907–2919 [<a href="/pmc/articles/PMC4671481/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4671481</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26264515" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26264515</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="niceng217er17.ref33">Watkins
|
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L, Shankar
|
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R. Reducing the risk of sudden unexpected death in epilepsy (SUDEP). Current Treatment Options in Neurology. 2018; 20(10):40 [<a href="https://pubmed.ncbi.nlm.nih.gov/30136125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30136125</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="niceng217er17.ref34">Watkins
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L, Shankar
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R, Sander
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JW. Identifying and mitigating sudden unexpected death in epilepsy (SUDEP) risk factors. Expert Review of Neurotherapeutics. 2018; 18(4):265–274 [<a href="https://pubmed.ncbi.nlm.nih.gov/29425076" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29425076</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="niceng217er17.ref35">Zhang
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WW, Si
|
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Y, Chen
|
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T, Chen
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D, Liu
|
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L, Deng
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Y
|
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et al
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Risks of probable SUDEP among people with convulsive epilepsy in rural West China. Seizure. 2016; 39:19–23 [<a href="https://pubmed.ncbi.nlm.nih.gov/27235892" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27235892</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng217er17.appa"><h3>Appendix A. Review protocols</h3><div id="niceng217er17.appa.s1"><h4>A.1. Review protocol for prediction of death/SUDEP</h4><p id="niceng217er17.appa.et1"><a href="/books/NBK581147/bin/niceng217er17-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (209K)</span></p></div><div id="niceng217er17.appa.s2"><h4>A.2. Health economic review protocol</h4><p id="niceng217er17.appa.et2"><a href="/books/NBK581147/bin/niceng217er17-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (178K)</span></p></div></div><div id="niceng217er17.appb"><h3>Appendix B. Literature search strategies</h3><p>This literature search strategy was used for the following reviews:
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<ul><li class="half_rhythm"><div>What are the most accurate tools for predicting a further seizure, in people who have had a single seizure?</div></li><li class="half_rhythm"><div>What are the most accurate tools to predicting death, including SUDEP, in people with epilepsy?</div></li></ul></p><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual.<a class="bibr" href="#niceng217er17.ref17" rid="niceng217er17.ref17"><sup>17</sup></a></p><p>For more information, please see the Methodology review published as part of the accompanying documents for this guideline.</p><div id="niceng217er17.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using the following approach:
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<ul><li class="half_rhythm"><div>Population AND risk factor terms</div></li></ul></p><p id="niceng217er17.appb.et1"><a href="/books/NBK581147/bin/niceng217er17-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 8. Database date parameters and filters used</a><span class="small"> (PDF, 165K)</span></p><div id="niceng217er17.appb.s1.1"><h5>Medline (Ovid) search terms</h5><p id="niceng217er17.appb.et2"><a href="/books/NBK581147/bin/niceng217er17-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (180K)</span></p></div><div id="niceng217er17.appb.s1.2"><h5>Embase (Ovid) search terms</h5><p id="niceng217er17.appb.et3"><a href="/books/NBK581147/bin/niceng217er17-appb-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (136K)</span></p></div></div><div id="niceng217er17.appb.s2"><h4>B.2. Health Economic literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to an Epilepsies population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional searches were run on Medline and Embase for health economics and quality of life studies.</p><p id="niceng217er17.appb.et4"><a href="/books/NBK581147/bin/niceng217er17-appb-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 9. Database date parameters and filters used</a><span class="small"> (PDF, 122K)</span></p><div id="niceng217er17.appb.s2.1"><h5>Medline (Ovid) search terms</h5><p id="niceng217er17.appb.et5"><a href="/books/NBK581147/bin/niceng217er17-appb-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (153K)</span></p></div><div id="niceng217er17.appb.s2.2"><h5>Embase (Ovid) search terms</h5><p id="niceng217er17.appb.et6"><a href="/books/NBK581147/bin/niceng217er17-appb-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (143K)</span></p></div><div id="niceng217er17.appb.s2.3"><h5>NHS EED and HTA (CRD) search terms</h5><p id="niceng217er17.appb.et7"><a href="/books/NBK581147/bin/niceng217er17-appb-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (117K)</span></p></div></div></div><div id="niceng217er17.appc"><h3>Appendix C. Diagnostic evidence study selection</h3><p id="niceng217er17.appc.et1"><a href="/books/NBK581147/bin/niceng217er17-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Figure 1. Flow chart of clinical study selection for the review of prediction of SUDEP/death from any cause</a><span class="small"> (PDF, 114K)</span></p></div><div id="niceng217er17.appd"><h3>Appendix D. Predictive evidence</h3><p id="niceng217er17.appd.et1"><a href="/books/NBK581147/bin/niceng217er17-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (222K)</span></p></div><div id="niceng217er17.appe"><h3>Appendix E. Risk of bias (PROBAST)</h3><p id="niceng217er17.appe.et1"><a href="/books/NBK581147/bin/niceng217er17-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (129K)</span></p></div><div id="niceng217er17.appf"><h3>Appendix F. Forest plots</h3><p>Not applicable</p></div><div id="niceng217er17.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng217er17.appg.et1"><a href="/books/NBK581147/bin/niceng217er17-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (132K)</span></p></div><div id="niceng217er17.apph"><h3>Appendix H. Economic evidence tables</h3><p>None.</p></div><div id="niceng217er17.appi"><h3>Appendix I. Health economic model</h3><p>No original economic modelling was undertaken for this review question.</p></div><div id="niceng217er17.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng217er17.appj.s1"><h4>J.1. Clinical studies</h4><p id="niceng217er17.appj.et1"><a href="/books/NBK581147/bin/niceng217er17-appj-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 10. Studies excluded from the clinical review</a><span class="small"> (PDF, 126K)</span></p></div><div id="niceng217er17.appj.s2"><h4>J.2. Health Economic studies</h4><p>Published health economic studies that met the inclusion criteria (relevant population, comparators, economic study design, published 2004 or later and not from non-OECD country or USA) but that were excluded following appraisal of applicability and methodological quality are listed below. See the health economic protocol for more details.</p><p id="niceng217er17.appj.et2"><a href="/books/NBK581147/bin/niceng217er17-appj-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 11. Studies excluded from the health economic review</a><span class="small"> (PDF, 117K)</span></p></div></div><div id="niceng217er17.appk"><h3>Appendix K. Research recommendations</h3><div id="niceng217er17.appk.s1"><h4>K.1. Development of a risk prediction tool for all-cause epilepsy-related death</h4><div id="niceng217er17.appk.s1.1"><h5>Why this is important</h5><p>The currently available risk tools for predicting epilepsy-related mortality (including SUDEP) have inadequate levels of predictive accuracy to allow reliable and safe prediction of epilepsy-related mortality. It is therefore critical for a new risk tool to be developed, ideally based on a large-scale cohort study.</p></div><div id="niceng217er17.appk.s1.2"><h5>Rationale for research recommendation</h5><p id="niceng217er17.appk.et1"><a href="/books/NBK581147/bin/niceng217er17-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (129K)</span></p></div><div id="niceng217er17.appk.s1.3"><h5>Modified PICO table</h5><p id="niceng217er17.appk.et2"><a href="/books/NBK581147/bin/niceng217er17-appk-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (119K)</span></p></div></div><div id="niceng217er17.appk.s2"><h4>K.2. External validation of a risk prediction tool to detect the probability of epilepsy-related death in people with epilepsy.</h4><div id="niceng217er17.appk.s2.1"><h5>Why this is important</h5><p>After a prediction tool has been developed using a specific cohort of patients it needs to be externally validated to demonstrate that it can accurately predict the outcome in other cohorts.</p></div><div id="niceng217er17.appk.s2.2"><h5>Rationale for research recommendation</h5><p id="niceng217er17.appk.et3"><a href="/books/NBK581147/bin/niceng217er17-appk-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (124K)</span></p></div><div id="niceng217er17.appk.s2.3"><h5>Modified PICO table</h5><p id="niceng217er17.appk.et4"><a href="/books/NBK581147/bin/niceng217er17-appk-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (114K)</span></p></div></div></div></div></div><div class="fm-sec"><div><p>Final version</p></div><div><p>Evidence review underpinning research recommendations in the NICE guideline.</p><p>Developed by the National Guideline Centre</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div><div class="small"><span class="label">Bookshelf ID: NBK581147</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35700291" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35700291</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng217er17tab1"><div id="niceng217er17.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng217er17.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng217er17.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Inclusion: People with a diagnosis of epilepsy.</p>
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<p>Exclusion: New-born babies with acute symptomatic seizures.</p>
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</td></tr><tr><th id="hd_b_niceng217er17.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Target condition</th><td headers="hd_b_niceng217er17.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epilepsy</td></tr><tr><th id="hd_b_niceng217er17.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prediction test</th><td headers="hd_b_niceng217er17.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any risk prediction tools for death, including SUDEP, used clinically, performed at baseline.</td></tr><tr><th id="hd_b_niceng217er17.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference standard</th><td headers="hd_b_niceng217er17.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Death/SUDEP during subsequent follow-up.</td></tr><tr><th id="hd_b_niceng217er17.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Statistical measures</th><td headers="hd_b_niceng217er17.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Discrimination: sensitivity, specificity, C statistic. These measures assess how accurately the tool can predict those who will and will not get SUDEP/die from any cause.</p>
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<p>Calibration: tests how well the tool results predict the absolute risk of getting SUDEP/dying from any cause.</p>
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<p>Net classification Improvement: a sensitive method for evaluating the different levels of predictive accuracy accruing from a change in the prediction tool. Follow up: use all available but stratify: <1 yr, 1–5 years, >5 years.</p>
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</td></tr><tr><th id="hd_b_niceng217er17.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng217er17.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Internal or external validation studies of the prediction tools. External validation studies (tested on a different study sample to the derivation sample) are preferred, although internal derivation studies (where the validation samples are different, but still drawn from the identical population to the derivation sample) will still be included with a downgrade for indirectness. These validation studies will almost certainly be prospective cohort studies, but retrospective cohort studies will be used if available.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab2"><div id="niceng217er17.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng217er17.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng217er17.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng217er17.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Predictive test</th><th id="hd_h_niceng217er17.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Reference standard (outcome event) definition</th><th id="hd_h_niceng217er17.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of outcome events</th><th id="hd_h_niceng217er17.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Follow up duration</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baysal-Kirac, 2017<a class="bibr" href="#niceng217er17.ref4" rid="niceng217er17.ref4"><sup>4</sup></a></td><td headers="hd_h_niceng217er17.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults of mean age 34.6 from secondary care in Turkey; AED resistant epilepsy; 21 M, 26F; TLE (n=20), extratemporal or multifocal epilepsy (n=27)</td><td headers="hd_h_niceng217er17.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP-7 inventory score</td><td headers="hd_h_niceng217er17.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP on autopsy</td><td headers="hd_h_niceng217er17.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unclear</td></tr><tr><td headers="hd_h_niceng217er17.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Novak, 2015<a class="bibr" href="#niceng217er17.ref19" rid="niceng217er17.ref19"><sup>19</sup></a></td><td headers="hd_h_niceng217er17.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults of mean age 33, from unclear setting in USA; AED resistant epilepsy; 10M, 15F; Type of epilepsy unclear</td><td headers="hd_h_niceng217er17.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP-7 inventory score (revised)</td><td headers="hd_h_niceng217er17.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP on autopsy</td><td headers="hd_h_niceng217er17.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_niceng217er17.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unclear</td></tr><tr><td headers="hd_h_niceng217er17.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Keezer, 2015<a class="bibr" href="#niceng217er17.ref12" rid="niceng217er17.ref12"><sup>12</sup></a></td><td headers="hd_h_niceng217er17.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults and children of median age 24.4 (13.8 – 56.1) in UK; people with newly suspected recurrent unprovoked epileptic seizures; 291M,267F; idiopathic/cryptogenic epilepsy 76.3%, remote symptomatic epilepsy 23.7%;</td><td headers="hd_h_niceng217er17.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Charlson Index</p>
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<p>The Elixhauser Index</p>
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<p>The Epilepsy-specific index</p>
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</td><td headers="hd_h_niceng217er17.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any mortality (on death certificate)</td><td headers="hd_h_niceng217er17.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">unclear</td><td headers="hd_h_niceng217er17.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.3 years</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab3"><div id="niceng217er17.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of prediction tools used in the included studies and constituent variables and cut-offs (where available)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk tool</th><th id="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Variables and scoring</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP-7 inventory score (original)</td><td headers="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 inventory score from 1 to 10, scored as follows: >3 generalised tonic clonic (GTCs) seizures in the past year (2 points), one or more GTCs in the past year (1 point), one or more seizures of any type over last 12 months (1 point), >50 seizures of any type per month over the last 12 months (2 points), >=30 years of epilepsy (3 points), currently using >=3 AEDs (1 point), IQ<70 (2 points); the standard threshold for higher/lower risk not provided in paper</td></tr><tr><td headers="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP-7 inventory score (revised to prevent score inflation)</td><td headers="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 inventory score from 1 to 10, scored as follows: >3 generalised tonic clonic (GTCs) seizures in past year (2 points), one or more GTCs in past year (1 point, but 0 points if already scored 2 points for >3 GTCs in past year), one or more seizures of any type over last 12 months (1 point, but 0 points if >50 seizures of any type per month), >50 seizures of any type per month over the last 12 months (2 points), >=30 years of epilepsy (3 points), currently using >=3 AEDs (1 point), IQ<70 (2 points); the standard threshold for higher/lower risk not provided in paper</td></tr><tr><td headers="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Charlson Index (for mortality generally, not SUDEP specifically)</td><td headers="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weighted scores were given to each of 19 co-morbidities: Myocardial infarct (1), Congestive heart failure (1), Peripheral vascular disease (1), Cerebrovascular disease (1), Dementia (1), Chronic pulmonary disease (1), Connective tissue disease (1), Ulcer disease (1), Mild liver disease (1), Diabetes (2), Hemiplegia (2), Moderate or severe renal disease (2), Diabetes with end-organ damage (2), Any tumour (2), Leukaemia (2), Lymphoma (2), moderate or severe liver disease (3), metastatic solid tumour (6), AIDS (6). Thresholds: low risk of death=0, low-medium=1, medium high=2, high>3</td></tr><tr><td headers="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Elixhauser index (for mortality generally, not SUDEP specifically)</td><td headers="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A weighted score is assigned to each of the 21 comorbid conditions, as follows: Drug abuse (−7), Obesity (−4), Depression (−3), Blood loss anaemia (−2), Deficiency anaemia (−2), Valvular disease (−1), Peripheral vascular disorders (2), Chronic pulmonary disease (2), Coagulopathy (3), Solid tumour without metastasis (3), Pulmonary circulation disorders (4), Renal failure (4), Cardiac arrhythmias (4), Fluid and electrolyte disorders (5), Neurodegenerative disorders (5), Weight loss (6), Paralysis (6), Congestive heart failure(7), Lymphoma (9), Liver disease (11), Metastatic cancer(12). Thresholds: low risk of death<0, low-medium=0, medium high=1–4, high≥5</td></tr><tr><td headers="hd_h_niceng217er17.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Epilepsy-specific index (for mortality generally, not SUDEP specifically)</td><td headers="hd_h_niceng217er17.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There are 14 comorbid conditions, in addition to age and sex, deemed to be significant predictors of mortality. These are as follows: Pulmonary circulation disorders (1), Hypertension (1), Cardiac arrhythmias (1), Congestive heart failure (2), Peripheral vascular disease (2), Renal disease (2), Solid tumour without metastasis (2), Paraplegia and hemiplegia (2), Aspiration pneumonia (2), Dementia(2), Brain tumour (3), Anoxic brain injury (3), Moderate or severe liver disease (3), Metastatic cancer (6). Thresholds: low risk of death=0, low-medium=1, medium high=2, high>3</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab4"><div id="niceng217er17.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3">Table 3</a>).</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng217er17.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Prediction tool</th><th id="hd_h_niceng217er17.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th id="hd_h_niceng217er17.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">n</th><th id="hd_h_niceng217er17.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th id="hd_h_niceng217er17.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th id="hd_h_niceng217er17.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th id="hd_h_niceng217er17.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th id="hd_h_niceng217er17.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Area Under Curve Individual study effects [point estimate (95% Cis)] Pooled effect/range/median</th><th id="hd_h_niceng217er17.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 inventory score</td><td headers="hd_h_niceng217er17.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng217er17.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Likely to be between 0.9 and 0.95, based on the area under the ROC curve produced by reviewer (as extrapolation of data provided in paper). No 95% CIs were calculable, but uncertainty around this point estimate is likely to be very high, hence the allocation of ‘very serious imprecision’ to this outcome</td><td headers="hd_h_niceng217er17.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 inventory score REVISED</td><td headers="hd_h_niceng217er17.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious<sup>b</sup></td><td headers="hd_h_niceng217er17.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Likely to be between 0.7 and 0.8, based on the area under the ROC curve produced by reviewer (as extrapolation of data provided in paper). No 95% CIs were calculable, but uncertainty around this point estimate is likely to be very high, hence the allocation of ‘very serious imprecision’ to this outcome</td><td headers="hd_h_niceng217er17.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a)</dt><dd><div id="niceng217er17.tab4_1"><p class="no_margin">Risk of bias was assessed using the PROBAST checklist (see <a href="#niceng217er17.appf">Appendix F</a>). Risk of bias was serious for all risk tools because none of the studies reported any blinding of assessors for risk tool data and outcome status.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b)</dt><dd><div id="niceng217er17.tab4_2"><p class="no_margin">The judgement of precision was based on the spread of confidence interval across two clinical thresholds: C statistics of 0.5 and 0.7. The threshold of 0.5 marked the boundary between no predictive value better than chance and a predictive value better than chance. The threshold of 0.7 marked the boundary above which the committee might consider recommendations. If the 95% Cis crossed one of these thresholds a rating of serious imprecision was given and if they crossed both of these thresholds a rating of very serious imprecision as given.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab5"><div id="niceng217er17.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Clinical evidence profile: sensitivity and specificity of prediction tools featured in the studies (see <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3">Table 3</a>).</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Prediction tool</th><th id="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">No of studies</th><th id="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">n</th><th id="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Sensitivity</th><th id="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Specificity</th><th id="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Risk of bias</th><th id="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Inconsistency</th><th id="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Indirectness</th><th id="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Imprecision</th><th id="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥1)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>1.0(0.025–1.0)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>0.0(0.0–0.071)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>Sensitivity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>specificity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥2)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>1.0(0.025–1.0)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>0.087(0.024–0.208)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>Sensitivity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>specificity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥3)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>1.0(0.025–1.0)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>0.283(0.160–0.435)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>Sensitivity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>specificity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious risk of imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥4)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>1.0(0.025–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
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<b>0.457(0.309–0.610)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
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<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
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<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥5)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.025–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.630(0.476–0.768)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥6)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.025–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.826(0.686–0.922)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥7)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.025–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.913(0.792–0.976)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥8)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.0(0.00–0.975)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.957(0.852–0.995)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool (threshold ≥9)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.0(0.00–0.975)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.978(0.885–0.999)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥1)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.158–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.0(0.0–0.148)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥2)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.158–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.261(0.102–0.484)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥3)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.158–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.348(0.164–0.573)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥4)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.158–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.478(0.268–0.694)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥5)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.5(0.126–0.987)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.826(0.612–0.951)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥6)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.5(0.126–0.987)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.913(0.720–0.989)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥7)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.0(0.0–0.842)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.957(0.781–0.999)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥8)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>0.0(0.0–0.842)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>1.0(0.852–1.0)</b>
|
|
</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Sensitivity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>specificity</b>
|
|
</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_1" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">SUDEP – 7 tool REVISED VERSION (threshold ≥9)</td><td headers="hd_h_niceng217er17.tab5_1_1_1_2" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab5_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_niceng217er17.tab5_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>0.0(0.0–0.842)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_5" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">
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<b>1.0(0.852–1.0)</b>
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</td><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>Sensitivity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of imprecision<sup>b</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">VERY LOW</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6 hd_h_niceng217er17.tab5_1_1_1_7 hd_h_niceng217er17.tab5_1_1_1_8 hd_h_niceng217er17.tab5_1_1_1_9 hd_h_niceng217er17.tab5_1_1_1_10" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">
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<b>specificity</b>
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</td></tr><tr><td headers="hd_h_niceng217er17.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Very serious risk of bias<sup>a</sup></td><td headers="hd_h_niceng217er17.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab5_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious imprecision</td><td headers="hd_h_niceng217er17.tab5_1_1_1_10" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">LOW</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a)</dt><dd><div id="niceng217er17.tab5_1"><p class="no_margin">Risk of bias was assessed using the PROBAST checklist. Risk of bias was serious for all risk tools because none of the studies reported any blinding of assessors for risk tool data.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b)</dt><dd><div id="niceng217er17.tab5_2"><p class="no_margin">Imprecision was assessed based on inspection of the confidence region in the meta-analysis or, where meta-analysis has not been conducted, assessed according to the range of confidence intervals in the individual studies. The evidence was downgraded by 1 increment when the confidence interval around the point estimate crossed one of the clinical thresholds (0.90 or 0.60 for sensitivity and 0.5 and 0.1 for specificity), and downgraded by 2 increments when the confidence interval around the point estimate crossed both of the clinical thresholds. The upper clinical threshold marked the point above which recommendations would be possible, and the lower clinical threshold marked the point below which the tool would be regarded as of little clinical use.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab6"><div id="niceng217er17.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Clinical evidence profile: Discriminative capacity (C statistic) of prediction tools featured in the studies (see <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3">table 3</a>).</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng217er17.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Prediction tool</th><th id="hd_h_niceng217er17.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th id="hd_h_niceng217er17.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">n</th><th id="hd_h_niceng217er17.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th id="hd_h_niceng217er17.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th id="hd_h_niceng217er17.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th id="hd_h_niceng217er17.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th id="hd_h_niceng217er17.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Area Under Curve Individual study effects [point estimate (95% Cis)] Pooled effect/range/median</th><th id="hd_h_niceng217er17.tab6_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Charlson Index</td><td headers="hd_h_niceng217er17.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unclear – assumed serious imprecision</td><td headers="hd_h_niceng217er17.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Harrel’s C<sup>c</sup>: 0.8703 (no uncertainty values given)</td><td headers="hd_h_niceng217er17.tab6_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MODERATE</td></tr><tr><td headers="hd_h_niceng217er17.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elixhauser Index</td><td headers="hd_h_niceng217er17.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unclear – assumed serious imprecision</td><td headers="hd_h_niceng217er17.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Harrel’s C: 0.8701 (no uncertainty values given)</td><td headers="hd_h_niceng217er17.tab6_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MODERATE</td></tr><tr><td headers="hd_h_niceng217er17.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epilepsy-specific Index</td><td headers="hd_h_niceng217er17.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unclear – assumed serious imprecision</td><td headers="hd_h_niceng217er17.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Harrel’s C: 0.8714 (no uncertainty values given)</td><td headers="hd_h_niceng217er17.tab6_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MODERATE</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a)</dt><dd><div id="niceng217er17.tab6_1"><p class="no_margin">Risk of bias was assessed using the PROBAST checklist (see <a href="#niceng217er17.appf">Appendix F</a>). Risk of bias was serious for all risk tools because none of the studies reported any blinding of assessors for risk tool data and outcome status.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b)</dt><dd><div id="niceng217er17.tab6_2"><p class="no_margin">The judgement of precision was based on the spread of confidence interval across two clinical thresholds: C statistics of 0.5 and 0.7. The threshold of 0.5 marked the boundary between no predictive value better than chance and a predictive value better than chance. The threshold of 0.7 marked the boundary above which the committee might consider recommendations. If the 95% Cis crossed one of these thresholds a rating of serious imprecision was given and if they crossed both of these thresholds a rating of very serious imprecision as given.</p></div></dd></dl><dl class="bkr_refwrap"><dt>c)</dt><dd><div id="niceng217er17.tab6_3"><p class="no_margin">Harrel’s C index is analogous to the AUC or C score; in that it provides an overall measure of accuracy at all thresholds. However, it is designed for use with Cox proportional hazard models.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng217er17tab7"><div id="niceng217er17.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Clinical evidence profile: Calibration (goodness of fit) (Schoenfeld p value) of prediction tools featured in the studies (see <a class="figpopup" href="/books/NBK581147/table/niceng217er17.tab3/?report=objectonly" target="object" rid-figpopup="figniceng217er17tab3" rid-ob="figobniceng217er17tab3">table 3</a>).</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK581147/table/niceng217er17.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng217er17.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng217er17.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Prediction tool</th><th id="hd_h_niceng217er17.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th id="hd_h_niceng217er17.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">n</th><th id="hd_h_niceng217er17.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th id="hd_h_niceng217er17.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th id="hd_h_niceng217er17.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th id="hd_h_niceng217er17.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th id="hd_h_niceng217er17.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Schoenfeld statistic p value <sup>a</sup> (<0.05 indicates proportionality assumption not met)</th><th id="hd_h_niceng217er17.tab7_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Quality</th></tr></thead><tbody><tr><td headers="hd_h_niceng217er17.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Charlson Index</td><td headers="hd_h_niceng217er17.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.1323</td><td headers="hd_h_niceng217er17.tab7_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HIGH</td></tr><tr><td headers="hd_h_niceng217er17.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elixhauser Index</td><td headers="hd_h_niceng217er17.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.3672</td><td headers="hd_h_niceng217er17.tab7_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HIGH</td></tr><tr><td headers="hd_h_niceng217er17.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epilepsy-specific Index</td><td headers="hd_h_niceng217er17.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng217er17.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">558</td><td headers="hd_h_niceng217er17.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious bias</td><td headers="hd_h_niceng217er17.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No serious indirectness</td><td headers="hd_h_niceng217er17.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NA</td><td headers="hd_h_niceng217er17.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.5597</td><td headers="hd_h_niceng217er17.tab7_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HIGH</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a)</dt><dd><div id="niceng217er17.tab7_1"><p class="no_margin">If the p value is <0.05 this indicates that linearity between predictor and the hazard of death (denoting calibration) is unlikely to be explained by sampling error.</p></div></dd></dl></dl></div></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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