The added value of risk assessment and subsequent targeted treatment for epileptic seizures after stroke: An early-HTA analysis

作者：Elles P. Elschot, Manuela Joore, Rob P.W. Rouhl, Rob J. Lamberts, Walter H. Backes, Jacobus F.A. Jansen · 发表于：Epilepsy & Behavior · 年份：2023 · DOI：10.1016/j.yebeh.2023.109594 · 研究领域：Epilepsy research and treatment、Acute Ischemic Stroke Management、EEG and Brain-Computer Interfaces

INTRODUCTION: The development of post-stroke epilepsy (PSE) is related to a worse clinical outcome in stroke patients. Adding a biomarker to the clinical diagnostic process for the prediction of PSE may help to establish targeted and personalized treatment for high-risk patients, which could lead to improved patient outcomes. We assessed the added value of a risk assessment and subsequent targeted treatment by conducting an early Health Technology Assessment. METHODS: Interviews were conducted with four relevant stakeholders in the field of PSE to obtain a realistic view of the current healthcare and their opinions on the potential value of a PSE risk assessment and subsequent targeted treatment. The consequences on quality of life and costs of current care of a hypothetical care pathway with perfect risk assessment were modeled based on information from a literature review and the input from the stakeholders. Subsequently, the maximum added value (the headroom) was calculated. Sensitivity analyses were performed to test the robustness of this result to variation in assumed input parameters, i.e. the accuracy of the risk assessment, the efficacy of anti-seizure medication (ASM), and the probability of patients expected to develop PSE. RESULTS: All stakeholders considered the addition of a predictive biomarker for the risk assessment of PSE to be of value. The headroom amounted to €12,983. The sensitivity analyses demonstrated that the headroom remained beneficial when varying...