Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

What are the appropriate circumstances and methods to screen for seizure disorders? In Allen Hauser's 1990 survey, "Epilepsy: Frequency, Causes, and Consequences", he estimates that 1 in 2500 people (42 per 100,000) have undiagnosed seizures. Given the expectation that the general public can only recognize tonic-clonic seizures as a medical problem, and given the probability that undiagnosed seizures will permit disease progression and intractibility, improved strategies for early diagnosis seem desirable. I have seen no analysis of whether these numbers have changed in the intervening years.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Possible intervention strategies include (a) improved education of the general public to enable them to identify other seizure types, (b) assessment of the ability of general practitioners to effectively detect seizure patients, (c) tools to make general practitioners more effective at identification, (d) cost-benefit analysis of whether to perform screening of higher-risk populations at appropriate interfaols.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Population screening (probably via EEG) may be appropriate for patients with Autism spectrum, cerebral palsy, or mental retardation, where high co-morbidity is well documented. It may also be appropriate for patients diagnosed with ADD (where missed diagnosis of absence seizures is plausible) and patients with a family history of seizures.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Populaton screening intervals would appropriately be matched to the ages when onset is most common e.g. early childhood, youth around puberty, and the elderly.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Reduced incidence of intractable epilepsy, reduced incidence of accidental injury from first-detected seizures.

Describe any health-related risks, side effects, or harms that you are concerned about.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

no

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

None

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

None

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

None

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

None

If yes, please explain:

None

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

None

Describe the timeframe in which an answer to your question is needed.

None

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

None

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

None

Are you making a suggestion as an individual or on behalf of an organization?

None

Please tell us how you heard about the Effective Health Care Program

None