Development and validation of a clinical prediction scale for pediatric focal cortical dysplasia type Ⅱ
10.3760/cma.j.cn101070-20240520-00310
- VernacularTitle:儿童局灶性皮质发育不良Ⅱ型临床预测量表的构建及验证
- Author:
Bocheng ZHOU
1
;
Yu SUN
;
Qingzhu LIU
;
Hao YU
;
Chang LIU
;
Yao WANG
;
Shuang WANG
;
Xiaoyan LIU
;
Yuwu JIANG
;
Lixin CAI
Author Information
1. 北京大学第一医院儿童癫痫中心，北京 102627
- Keywords:
Malformation of cortical development;
Focal cortical dysplasia type Ⅱ;
Preoperative evaluation of epilepsy;
Pediatric epilepsy surgery
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(8):579-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a clinical prediction scale for focal cortical dysplasia (FCD)type Ⅱ in the malformation of cortical development (MCD) disease spectrum in children.Methods:A case-sectional study.From January 2014 to June 2019, patients who underwent surgery at the Pediatric Epilepsy Center of Peking University First Hospital and were pathologically diagnosed with MCD after surgery were enrolled and randomly divided into the training set and the validation set using random numbering.Clinical, electrophysiological, and imaging data of patients in the training set were analyzed.Variables that could predict FCD type Ⅱ were screened out using a Logistic regression model, and a rating scale was constructed.The diagnostic efficiency of the scale was validated in the validation set to determine the optimum cut-off value, and a consistency test was performed.Results:A total of 381 patients were enrolled in the study, with 260 in the training set and 121 in the validation set.Five clinical factors that exhibited a significant correlation with FCD type Ⅱ were identified in the training set through the logistic regression model: (1) age of seizure onset (<24 months); (2) lesion involving the frontal lobe; (3) epileptic spasms; (4) family history of epilepsy; (5) hippocampal atrophy ± signal change.Based on these 5 variables, the FCD type Ⅱ prediction scale was developed and validated in the validation set with an area under the curve of 0.732.The optimum cut-off value for the prediction scale was 1, at which point the Youden index was 0.384.The scale′s positive predictive value was 0.836, and the negative predictive value was 0.500.The diagnostic consistency between the pathological diagnosis and the FCD type Ⅱ prediction scale was acceptable (Kappa value=0.351), and there was no statistically significant difference between the two diagnostic methods ( P value of the McNemar test=0.065). Conclusions:The FCD type Ⅱ prediction scale has clinical practicability.The application of this scale to predict the pathological type of MCD before operation can help doctors choose the appropriate surgical strategy.
