RELIABILITY OF SEIZURE CLASSIFICATION USING A SEMISTRUCTURED INTERVIEW

Methods for standardized classification of epileptic seizures are impo rtant for both clinical practice and epidemiologic research. In this s tudy, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria . We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the seizure history, we also int erviewed a first-degree relative for 67% of subjects and obtained medi cal records for 59%. Three lay reviewers used all available informatio n to classify seizures. To assess reliability, each reviewer classifie d a sample of subjects assigned to the others. In addition, an expert physician classified a sample of subjects assigned to two of the revie wers. Agreement was ''moderate-substantial'' for generalized-onset sei zures, both for the comparisons between pairs of lay reviewers and for the neurologist versus lay reviewers. Agreement was 'substantial-almo st perfect' for partial-onset seizures, both for pairs of lay reviewer s and for the neurologist versus lay reviewers. These results suggest that seizures can be reliably classified by lay reviewers, using opera tional criteria applied to symptoms ascertained in a semistructured te lephone interview.