Crowdsourcing reproducible seizure forecasting in human and canine epilepsy.

SEE MORMANN AND ANDRZEJAK DOI101093/BRAIN/AWW091 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE : Accurate forecasting of epileptic seizures has the potential to transform clinical epilepsy care. However, progress toward reliable seizure forecasting has been hampered by lack of open access to long duration recordings with an adequate number of seizures for investigators to rigorously compare algorithms and results. A seizure forecasting competition was conducted on kaggle.com using open access chronic ambulatory intracranial electroencephalography from five canines with naturally occurring epilepsy and two humans undergoing prolonged wide bandwidth intracranial electroencephalographic monitoring. Data were provided to participants as 10-min interictal and preictal clips, with approximately half of the 60 GB data bundle labelled (interictal/preictal) for algorithm training and half unlabelled for evaluation. The contestants developed custom algorithms and uploaded their classifications (interictal/preictal) for the unknown testing data, and a randomly selected 40% of data segments were scored and results broadcasted on a public leader board. The contest ran from August to November 2014, and 654 participants submitted 17 856 classifications of the unlabelled test data. The top performing entry scored 0.84 area under the classification curve. Following the contest, additional held-out unlabelled data clips were provided to the top 10 participants and they submitted classifications for the new unseen data. The resulting area under the classification curves were well above chance forecasting, but did show a mean 6.54 ± 2.45% (min, max: 0.30, 20.2) decline in performance. The kaggle.com model using open access data and algorithms generated reproducible research that advanced seizure forecasting. The overall performance from multiple contestants on unseen data was better than a random predictor, and demonstrates the feasibility of seizure forecasting in canine and human epilepsy.media-1vid110.1093/brain/aww045_video_abstractaww045_video_abstract.

Attitudes toward epilepsy among the primary and secondary school teachers in Malaysia, using the public attitudes toward epilepsy (PATE) scale.

INTRODUCTION: There is a lack of study comparing the attitudes toward epilepsy between the teachers and general population, teachers and students, using a similar quantitative scale. METHODS: This study was performed in one primary and one secondary school in Kuala Lumpur, Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale. RESULTS: A total of 186 teachers aged 39.6±10.4 years completed the questionnaire. The mean scores in both personal and general domains of PATE scale were significantly better in the teachers, comparing to the scores in the secondary and college students reported in previous study (Lim et al., 2013; p<0.001 and <0.05, respectively). The mean scores in personal domain was significantly better in the teachers, comparing to the general population reported by Lim et al. (2012; p<0.001). This hold true when comparing teachers with general population with tertiary education, suggesting that the better attitude is specific to the job, rather than tertiary education generally. Subanalysis showed that the attitudes of teachers were significantly better than the general population and the students related to employment and social life, but were equally negative on issues directly related to education, such as placing children with epilepsy in regular classes. CONCLUSION: Teachers had more positive attitudes toward epilepsy as compared with the general population with tertiary education. Attitude to epilepsy may differ specific to types of work.

A web-based survey of attitudes toward epilepsy in secondary and tertiary students in Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale.

BACKGROUND: Students' attitudes toward epilepsy have been studied in several countries, but none of the studies used a quantitative scale. We aimed to determine the validity and reliability of the Public Attitudes Toward Epilepsy (PATE) scale in a homogenous population consisting of secondary and tertiary students in Malaysia and to quantify their attitudes toward epilepsy, using a web-based survey. RESULTS: A total of 227 respondents with a mean age of 19.6±2.07 years, predominantly Chinese (85%), female (62%), and in a pre-university education level (71%) completed the web-based survey. Psychometric testing showed that the PATE is a valid and reliable scale to be applied in a homogenous population. The mean score in the personal domain was significantly higher than that in the general domain (2.73±0.61 vs. 2.12±0.60, respectively, p<0.001). Compared with a study previously performed on a general population (Lim et al., 2012 [10]), the mean score in the general domain was significantly lower (p<0.01), whereas there was no significant difference between the mean scores in the personal domain. The mean scores in the general domain were significantly lower for those with tertiary education (p<0.001) but did not correlate with gender and ethnicity. CONCLUSION: The attitudes of secondary and tertiary students are more positive than those of the general population in the general domain but not in the personal domain.

Regression models for relative survival.

Four approaches to estimating a regression model for relative survival using the method of maximum likelihood are described and compared. The underlying model is an additive hazards model where the total hazard is written as the sum of the known baseline hazard and the excess hazard associated with a diagnosis of cancer. The excess hazards are assumed to be constant within pre-specified bands of follow-up. The likelihood can be maximized directly or in the framework of generalized linear models. Minor differences exist due to, for example, the way the data are presented (individual, aggregated or grouped), and in some assumptions (e.g. distributional assumptions). The four approaches are applied to two real data sets and produce very similar estimates even when the assumption of proportional excess hazards is violated. The choice of approach to use in practice can, therefore, be guided by ease of use and availability of software. We recommend using a generalized linear model with a Poisson error structure based on collapsed data using exact survival times. The model can be estimated in any software package that estimates GLMs with user-defined link functions (including SAS, Stata, S-plus, and R) and utilizes the theory of generalized linear models for assessing goodness-of-fit and studying regression diagnostics.

New Zealand community attitudes toward people with epilepsy.

PURPOSE: International surveys on knowledge and attitudes toward people with epilepsy suggest that public opinion is improving in many countries. This study aimed to discover how New Zealand compared with other countries, and how subgroups within the New Zealand population compared with each other, by conducting a survey of community knowledge and attitudes toward epilepsy. METHODS: Telephone interviews were conducted on a random sample of 400 persons older than 17 years, drawn from a mid-sized provincial town and its hinterland. RESULTS: Ninety-five percent of respondents had heard or read about epilepsy; 73% knew someone with epilepsy; and 67% had seen an epileptic seizure. Somewhat less knowledgeable were young people, the less educated, lower socioeconomic status (SES), and those of Maori or non-European ethnicity. Attitudes toward people with epilepsy were favorable, with only 5% objecting to their child marrying a person who sometimes had seizures. Less-positive attitudes were found among some older people. CONCLUSIONS: Compared with those in other Western countries, New Zealanders are well informed about epilepsy, and their attitudes toward it are mainly positive. Continuing public education about epilepsy is still necessary, especially among the young, the non-European, and older people.