J Clin Neurol.  2016 Oct;12(4):434-440. 10.3988/jcn.2016.12.4.434.

Estimating the Prevalence of Treated Epilepsy Using Administrative Health Data and Its Validity: ESSENCE Study

Affiliations
  • 1Department of Neurology, Kangwon National University College of Medicine, Chuncheon, Korea.
  • 2Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea. hkcheong@skku.edu
  • 3Department of Neurology, Konkuk University, School of Medicine, Seoul, Korea.
  • 4Department of Pediatrics, Korea University College of Medicine, Ansan, Korea.
  • 5Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
  • 7YiSangDo Neurology Clinic, Daegu, Korea.
  • 8Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. jungky@snu.ac.kr

Abstract

BACKGROUND
AND PURPOSE: Few of the epidemiologic studies of epilepsy have utilized well-validated nationwide databases. We estimated the nationwide prevalence of treated epilepsy based on a comprehensive medical payment database along with diagnostic validation.
METHODS
We collected data on patients prescribed of antiepileptic drugs (AEDs) from the Health Insurance Review and Assessment service, which covers the entire population of Korea. To assess the diagnostic validity, a medical records survey was conducted involving 6,774 patients prescribed AEDs from 43 institutions based on regional clusters and referral levels across the country. The prevalence of treated epilepsy was estimated by projecting the diagnostic validity on the number of patients prescribed AEDs.
RESULTS
The mean positive predictive value (PPV) for epilepsy was 0.810 for those prescribed AEDs with diagnostic codes that indicate epilepsy or seizure (Diagnosis-E), while it was 0.066 for those without Diagnosis-E. The PPV tended to decrease with age in both groups, with lower values seen in females. The prevalence was 3.84 per 1,000, and it was higher among males, children, and the elderly.
CONCLUSIONS
The prevalence of epilepsy in Korea was comparable to that in other East Asian countries. The diagnostic validity of administrative health data varies depending on the method of case ascertainment, age, and sex. The prescriptions of AEDs even without relevant diagnostic codes should be considered as a tracer for epilepsy.

Keyword

epilepsy; seizure; prevalence; health data; epidemiology; validation
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