Self-management interventions in pediatric epilepsy: What is the level of evidence?

摘要: SummaryObjective To respond to recommendations put forth by the Institute of Medicine improve self-management resources for youth with epilepsy conducting a systematic review literature in pediatric epilepsy. Methods Inclusion criteria: birth 18 years seizure disorder or an diagnosis and/or their caregivers, published 1985–2014 English, and conducted countries very high human development index. Abstract keywords had explicitly refer “self-care” (pre-1996) (post-1996). The was seven phases: (1) identification bibliographical search criteria databases; (2) abstract assessment; (3) full article review; (4) organization final citations into instrument development, intervention, factors associated categories; (5) American Academy Neurology level evidence (LOE) assessment intervention studies; (6) CONsolidated Standards Reporting Trials (CONSORT) evaluation LOE III articles utilizing control group; (7) categorization outcomes across four domains. Results Of 87 that met eligibility criteria, 24 were interventions received scores IV. Most studies (n = 20, 80%) scored at III; however, only eight group adhered CONSORT guidelines. They largely neglected information on components (e.g., implementation, treatment fidelity), randomization, participant flow, missing data, effect size confidence intervals. reported significant impact domains: individual 13), family 6), health care system 3), community 2). Significance There are no I II studies. No study Outcomes well described; nature multiple foci, skills targeted) observed heterogeneity complicates comparisons Randomized controlled trials (RCTs) include large sample sizes, fidelity, power analyses necessary further this base.