Provider and Patient SUDEP-7 Scoring: A Prospective Pilot Study (P1.282)

Objective: We aimed to determine whether patient and provider ratings of the Sudden Unexpected Death in Epilepsy (SUDEP) Risk Inventory (SUDEP-7) scores were concordant, and which specific items were best correlated between raters. Background: Sudden unexpected death in epilepsy (SUDEP) accounts for significant mortality in patients with drug resistant epilepsy (DRE). The SUDEP-7 quantifies risk for SUDEP using population-based risk factors, and has been previously correlated with factors that may portend SUDEP such as heart rate variability and ictal cerebral hypoxia. Design/Methods: We distributed questionnaires to patients with DRE (n=181) in our epilepsy monitoring unit, and asked providers to rate these same patients following interview while remaining blinded to patient scores. Patients with psychological or other non-epileptic spells were excluded. Agreement between patient and provider ratings was determined by kappa statistics, and level of agreement for individual Inventory items was determined by factor analysis using JMP software. Results: Overall there was good agreement (Spearman correlation coefficient 0.61) between patient and provider rated SUDEP-7 scores. The factors that correlated best between the raters included u003e=1 GTCS (kappa−0.72), u003e=3 GTCS (kappa−0.62) and u003e3 AEDs (kappa−0.69). Factors that were poorly correlated were u003e1 any seizure type in last 12 months (kappa−0.35) and u003e50 any seizure type per month in last 12 months (kappa−0.33). Overall mean SUDEP-7 score values were similar between the raters, mean provider score= 2.0 (SD 1.96, range 0–10), mean patient score=2.2 (SD 1.72, range 0–8). Conclusions: Agreement between patient and provider SUDEP-7 ratings was good, indicating that patient or provider completion of SUDEP-7 surveys is reasonable. Further development of surveys and approaches for self-administered SUDEP-7 scoring is needed to improve discrepancies between patient and provider ratings. Disclosure: Dr. Kiernan has nothing to disclose. Dr. Jaliparthy has nothing to disclose. Dr. Chahal has nothing to disclose. Dr. Myburgh has nothing to disclose. Dr. Bredesen has nothing to disclose. Dr. Timm has nothing to disclose. Dr. Britton has nothing to disclose. Dr. Cascino has received personal compensation in an editorial capacity for American Academy of Neurology and the journal Neurology. Dr. Cascino holds stock and/or stock options in Nevro through Mayo Medical ventures. Dr. Worrell has nothing to disclose. Dr So has nothing to disclose. Dr. Somers has nothing to disclose. Dr. St. Louis has nothing to disclose.