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We compared four multivariate models: \u201cMTS,\u201d using just evidence of MTS; \u201cFULL,\u201d using all eight binary predictors; \u201cAIC\u201d using backwards selection of variables; and \u201cSCORE,\u201d using a 0\u2010to\u20108\u2010point ordinal score awarding one point for each binary predictor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In univariate analysis, significant predictors for seizure freedom were evidence of mesial temporal sclerosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.011, Fisher exact) and unitemporal interictal discharges (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). For multivariate prediction (using leave one\u2010out cross\u2010validation), the ordinal SCORE model had a significantly higher area under the curve (AUC 0.70) than the other three models: MTS (AUC 0.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.002, Delong's test), FULL (AUC 0.62, <jats:italic>p<\/jats:italic>\u2009=\u20090.003), or AIC (AUC 0.53, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>An ordinal score incorporating eight independent binary clinical variables predicted seizure freedom better on novel data than a model using MTS alone, a full multivariate model, or a backwards selected model. The ordinal score model represents a simple clinical heuristic to identify which patients should be offered minimally invasive laser surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52146","type":"journal-article","created":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T05:54:43Z","timestamp":1720850083000},"page":"2327-2336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["An ordinal clinical score predicts seizure freedom after minimally invasive epilepsy surgery"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4710-1290","authenticated-orcid":false,"given":"Adam S.","family":"Dickey","sequence":"first","affiliation":[{"name":"Department of Neurology Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L.","family":"Bullinger","sequence":"additional","affiliation":[{"name":"Department of Neurology Emory University 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