0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Limitations of NIS Database in Evaluation of Epilepsy Surgery Morbidity and Mortality

Kitti Kaiboriboon, MD; Nicholas Schiltz; Siran M. Koroukian, MSN, MHA, PhD; Samden D. Lhatoo, MD; Mohamad Z. Koubeissi, MD
Arch Neurol. 2011;68(11):1483-1484. doi:10.1001/archneurol.2011.222.
Text Size: A A A
Published online

Extract

McClelland et al1 analyzed the Nationwide Inpatient Sample (NIS) database from 1988 to 2003 with the aim of assessing the morbidity and mortality of anterior temporal lobectomy (ATL) in patients with intractable temporal lobe epilepsy (TLE). They concluded that ATL is safe, with low morbidity and no mortality. This is an important and timely contribution to the literature, as emphasized by the excellent accompanying editorial that details the importance of using what is often highly effective surgical intervention for otherwise refractory focal epilepsy. However, the results should perhaps have been reported as including all refractory focal epilepsies rather than just TLE and all resective epilepsy surgeries rather than just temporal lobectomies. The investigators used International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify patients with TLE (ICD-9-CM codes 345.41 or 345.51) and ATL (ICD-9-CM code 01.53). These codes are not specific for either TLE or ATL. Indeed, patients with intractable focal epilepsy originating from frontal, parietal, or occipital lobes are also coded as either 345.41 or 345.51 depending on the characteristics of their seizures (complex vs simple partial seizures). Similarly, any lobectomy is coded as 01.53. McClelland et al1 listed a number of limitations but did not mention this coding limitation, which may possibly change their conclusions significantly.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

November 1, 2011
Shearwood McClelland, MD; Hongfei Guo, PhD; Kolawole S. Okuyemi, MD, MPH
Arch Neurol. 2011;68(11):1483-1484. doi:10.1001/archneurol.2011.223.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();