External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy

doi:10.1186/s12884-023-05822-z

科研成果详情

题名	External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy
作者	Du, Yanru; Xu, Qi; Lin, Jiahe; Gong, Jiaoni; Xia, Niange; Zhu, Zhenguo; Wang, Xinshi; Zheng, Rongyuan; Xu, Huiqin
发表日期	2023-07-11
发表期刊	BMC PREGNANCY AND CHILDBIRTH 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Pregnant women with epilepsy Predict seizures The EMPiRE model External validation
其他关键词	OPERATIONAL CLASSIFICATION ; ILAE COMMISSION ; POSITION PAPER ; COMPLICATIONS ; MANAGEMENT
摘要	BackgroundThe AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model is the only available tool for predicting seizures in pregnant women with epilepsy (WWE) using anti-seizure medications (ASMs); however, its predictive performance requires validation. This study aimed to evaluate the predictive ability of this model in pregnant Chinese WWE and its potential usefulness in clinical practice.MethodsData of the EMPiRE model were derived from the EMPiRE study, a prospective multicenter cohort study that recruited women on ASM monotherapy (lamotrigine, carbamazepine, phenytoin or levetiracetam) or polytherapy (lamotrigine with either carbamazepine, phenytoin or levetiracetam). Based on the applicable population of the EMPiRE model, we evaluated 280 patients registered in the Wenzhou Epilepsy Follow-up Registry Database from January 1, 2010, to December 31, 2020. A total of 158 eligible patients were included in the validation cohort. We collected data on the baseline characteristics of patients, eight predictors of the EMPiRE model and outcome events. The outcome was the occurrence of tonic-clonic or non-tonic-clonic seizures at any time in pregnancy up to 6 weeks postpartum. We used the equation of the EMPiRE model to obtain the predicted probabilities of seizures. The predictive ability of the EMPiRE model was quantified by the C-statistic (scale 0-1, values > 0.5 show discrimination), GiViTI calibration test and decision curve analysis (DCA).ResultsOf 158 eligible patients, 96 patients (60.8%, 96/158) experienced one or more seizures at any time between pregnancy and 6 weeks postpartum. The EMPiRE model showed good discrimination with a C-statistic of 0.76 (95% confidence interval [CI] 0.70-0.84). The GiViTI calibration belt showed that the predicted probabilities, which ranged from 16 to 96% (95% CI), were lower than the actual probabilities. DCA indicated that the highest net proportional benefit was obtained for predicted probability thresholds of 15-18% and 54-96%.ConclusionsThe EMPiRE model could discriminate well between WWE with and without seizures during pregnancy and 6 weeks postpartum, but the risk of seizures may be underestimated. The limitations of the model for specific medication regimens may limit its real-world application. If the model is further improved, it will be incredibly valuable.
出版者	BMC
ISSN	1471-2393
EISSN	1471-2393
卷号	23 期号:1
DOI	10.1186/s12884-023-05822-z
页数	10
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
WOS记录号	WOS:001026458600004
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	37434124
SCOPUSEID	2-s2.0-85164391807
通讯作者地址	[Xu, Huiqin]Department of Neurology,the First Affiliated Hospital of Wenzhou Medical University,Shangcai village, Ouhai District, Zhejiang Province,Wenzhou,China
Scopus学科分类	Obstetrics and Gynecology
TOP期刊	TOP期刊
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/181642
专题	第一临床医学院（信息与工程学院）、附属第一医院_内科学_神经内科
通讯作者	Xu, Huiqin
作者单位	Department of Neurology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
第一作者单位	第一临床医学院（信息与工程学院）、附属第一医院_内科学_神经内科
通讯作者单位	第一临床医学院（信息与工程学院）、附属第一医院_内科学_神经内科
第一作者的第一单位	第一临床医学院（信息与工程学院）、附属第一医院_内科学_神经内科
推荐引用方式 GB/T 7714	Du, Yanru,Xu, Qi,Lin, Jiahe,et al. External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy[J]. BMC PREGNANCY AND CHILDBIRTH,2023,23(1).
APA	Du, Yanru., Xu, Qi., Lin, Jiahe., Gong, Jiaoni., Xia, Niange., ... & Xu, Huiqin. (2023). External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy. BMC PREGNANCY AND CHILDBIRTH, 23(1).
MLA	Du, Yanru,et al."External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy".BMC PREGNANCY AND CHILDBIRTH 23.1(2023).