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    United States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers.

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    Author
    Ostendorf, Adam P
    Ahrens, Stephanie M
    Lado, Fred Alexander
    Arnold, Susan T
    Bai, Shasha
    Bensalem Owen, Meriem K
    Chapman, Kevin E
    Clarke, Dave F
    Eisner, Mariah
    Fountain, Nathan B
    Gray, Johanna M
    Hopp, Jennifer L
    Riker, Ellen
    Schuele, Stephan U
    Small, Barbara V
    Herman, Susan T
    Show allShow less

    Date
    2021-12-08
    Journal
    Neurology
    Publisher
    Lippincott Williams and Wilkins
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1212/WNL.0000000000013130
    PMC8826463
    Abstract
    Background and objectives: Patients with drug-resistant epilepsy (DRE) may benefit from specialized testing and treatments to better control seizures and improve quality of life. Most evaluations and procedures for DRE in the United States are performed at epilepsy centers accredited by the National Association of Epilepsy Centers (NAEC). On an annual basis, the NAEC collects data from accredited epilepsy centers on hospital-based epilepsy monitoring unit (EMU) size and admissions, diagnostic testing, surgeries, and other services. This article highlights trends in epilepsy center services from 2012 through 2019. Methods: We analyzed data reported in 2012, 2016, and 2019 from all level 3 and level 4 NAEC accredited epilepsy centers. Data were described using frequency for categorical variables and median for continuous variables and were analyzed by center level and center population category. EMU beds, EMU admissions, epileptologists, and aggregate procedure volumes were also described using rates per population per year. Results: During the period studied, the number of NAEC accredited centers increased from 161 to 256, with the largest increases in adult- and pediatric-only centers. Growth in EMU admissions (41%), EMU beds (26%), and epileptologists (109%) per population occurred. Access to specialized testing and services broadly expanded. The largest growth in procedure volumes occurred in laser interstitial thermal therapy (LiTT) (61%), responsive neurostimulation (RNS) implantations (114%), and intracranial monitoring without resection (152%) over the study period. Corpus callosotomies and vagus nerve stimulator (VNS) implantations decreased (-12.8% and -2.4%, respectively), while growth in temporal lobectomies (5.9%), extratemporal resections (11.9%), and hemispherectomies/otomies (13.1%) lagged center growth (59%), leading to a decrease in median volumes of these procedures per center. Discussion: During the study period, the availability of specialty epilepsy care in the United States improved as the NAEC implemented its accreditation program. Surgical case complexity increased while aggregate surgical volume remained stable or declined across most procedure types, with a corresponding decline in cases per center. This article describes recent data trends and current state of resources and practice across NAEC member centers and identifies several future directions for driving systematic improvements in epilepsy care.
    Rights/Terms
    Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17978
    ae974a485f413a2113503eed53cd6c53
    10.1212/WNL.0000000000013130
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