{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:06:46Z","timestamp":1747184806736,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T00:00:00Z","timestamp":1608422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Treatment delays for refractory convulsive status epilepticus (RCSE) are associated with worse outcomes. In the United States, treatment for pediatric RCSE is slower than guidelines recommend. To address this gap, the American Academy of Neurology and Child Neurology Society (AAN\/CNS) developed a quality measure: the percentage of RCSE patients that receive third\u2010line treatment within 60\u00a0minutes. We aimed to develop computable phenotypes for convulsive status epilepticus (CSE) and RCSE to automate calculation of the quality measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From an observational cohort of children presenting to the emergency department for seizures or epilepsy, we identified presentations of RCSE and its precursors: CSE and benzodiazepine\u2010resistant status epilepticus (BRSE). These served as a gold standard for computable phenotype development. Using multivariate analyses, we constructed and evaluated statistical models for case identification. We then evaluated adherence to the AAN\/CNS RCSE quality measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 664 charts, we identified 56 patients with CSE, 36 with BRSE, and 18 with RCSE. Four predictors were used: International Classification of Diseases (ICD) codes, and receiving first\u2010, second\u2010, or third\u2010line agents shortly after presentation to the emergency department (ED). Combinations of these predictors identified CSE with 84% sensitivity and 81% positive predictive value (PPV), BRSE with 67% sensitivity and 89% PPV, and RCSE with 94% sensitivity and 85% PPV. Median (interquartile range [IQR]) time to treatment for first\u2010line agent was 13 (5\u201027) minutes for CSE, second\u2010line for BRSE was 24 (9.5\u201043.5) minutes, and third\u2010line for RCSE was 52 (27\u201087) minutes. Sixty percent of RCSE patients received a third\u2010line agent within 60\u00a0minutes of ED arrival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>RCSE and its precursors can be identified automatically with high fidelity allowing automated calculation of time to treatment and the RCSE quality measure. This has the potential to facilitate quality improvement work and improve care for RCSE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16795","type":"journal-article","created":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T16:09:30Z","timestamp":1608480570000},"page":"337-346","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Automated identification and quality measurement for pediatric convulsive status epilepticus"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2835-4076","authenticated-orcid":false,"given":"David L.","family":"Hess\u2010Homeier","sequence":"first","affiliation":[{"name":"Weill Cornell Medical College New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karishma","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Neurology NewYork\u2010Presbyterian Hospital Weill Cornell Medical Center New York NY USA"},{"name":"NewYork\u2010Presbyterian Hospital New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Basma","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy &amp; Research Weill Cornell Medicine New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam E.","family":"Vella","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College New York NY USA"},{"name":"NewYork\u2010Presbyterian Hospital New York NY USA"},{"name":"Department of Emergency Medicine NewYork\u2010Presbyterian Hospital Weill Cornell Medical Center New York NY USA"},{"name":"Department of Pediatrics NewYork\u2010Presbyterian Hospital Weill Cornell Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-0932","authenticated-orcid":false,"given":"Zachary M.","family":"Grinspan","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College New York NY USA"},{"name":"NewYork\u2010Presbyterian Hospital New York NY USA"},{"name":"Department of Healthcare Policy &amp; Research Weill Cornell Medicine New York NY USA"},{"name":"Department of Pediatrics NewYork\u2010Presbyterian Hospital Weill Cornell Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13121"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70546-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.1268"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.4382"},{"key":"e_1_2_8_6_1","article-title":"Timing in the treatment of status epilepticus: From basics to the clinic","author":"Gainza\u2010Lein M","year":"2018","journal-title":"Seizure"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.5698\/1535-7597-16.1.48"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2018.06.004"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001673"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005488"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2003.12.012"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010174"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004806"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001902"},{"key":"e_1_2_8_15_1","unstructured":"Crossing the Quality Chasm: A New Health System for the 21st Century. Washington; (DC). 2001."},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.2517-6161.1996.tb02080.x","article-title":"Regression shrinkage and selection via the Lasso","volume":"58","author":"Tibshirani R","year":"1996","journal-title":"J Roy Stat Soc B Met"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118432"},{"volume-title":"R: A language and environment for statistical computing","year":"2013","author":"Team RC","key":"e_1_2_8_18_1"},{"key":"e_1_2_8_19_1","article-title":"Protocol\u2010Driven Management of Convulsive Status Epilepticus at a Tertiary Children's Hospital: A Quality Improvement Initiative","author":"Cassel\u2010Choudhury G","year":"2018","journal-title":"Pediatr Crit Care Med"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073816664670"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2018.05.012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2310\/8000.2013.131131"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073812474950"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.04.011"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.08.015"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073817698629"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.3.759"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-99713-1_8"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.08.021"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16795","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/epi.16795","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16795","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T17:25:45Z","timestamp":1724088345000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.16795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,20]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/epi.16795"],"URL":"https:\/\/doi.org\/10.1111\/epi.16795","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"type":"print","value":"0013-9580"},{"type":"electronic","value":"1528-1167"}],"subject":[],"published":{"date-parts":[[2020,12,20]]},"assertion":[{"value":"2020-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}