How accurate are witnesses of first suspected seizures in recalling semiology at clinically relevant timepoints? A UK experimental study with a pilot intervention.
Saved in:
| Title: | How accurate are witnesses of first suspected seizures in recalling semiology at clinically relevant timepoints? A UK experimental study with a pilot intervention. |
|---|---|
| Authors: | Noble, Adam J. (AUTHOR), Lane, Steven (AUTHOR), New, Paul (AUTHOR), Cope, Harriet (AUTHOR), Foley, Chloe (AUTHOR), Williams, Holly Lynn (AUTHOR), Sztriha, Laszlo (AUTHOR), Powell, Graham (AUTHOR), Reuber, Markus (AUTHOR), Marson, Anthony G. (AUTHOR) |
| Source: | Epilepsia (Series 4). Dec2025, Vol. 66 Issue 12, p4795-4808. 14p. |
| Subjects: | Seizures (Medicine), Epilepsy, Pilot projects, Recollection (Psychology), Clinical trials, Diagnostic errors |
| Geographic Terms: | United Kingdom |
| Abstract: | Objective: A key diagnostic challenge at "first seizure" clinic appointments is determining whether the reported event was epileptic. Witness accounts are often critical, yet such appointments typically occur weeks after the event. Guidelines recommend review within 2 weeks. Wait times are however often longer, with a median of 7 weeks in countries such as the UK. The accuracy of witness recall at these clinically relevant intervals and whether their confidence predicts accuracy have never been determined. This study addressed these fundamental questions. It also piloted a potential intervention: whether asking witnesses a set of systematic questions immediately after viewing a suspected seizure improves recall at follow‐up, compared to the usual free recall approach used by first responders. Methods: In this UK‐based experimental study, adults (≥18 years old) viewed a video of an epileptic seizure and were randomized into four conditions: A (immediate free recall + 2‐week follow‐up), B (immediate free recall + 7‐week follow‐up), C (immediate systematic questions + 2‐week follow‐up), and D (immediate systematic questions + 7‐week follow‐up). The primary outcome was accuracy on 15 standardized questions addressing key semiological features, scored against consensus ratings from five neurologists. Results: Of a representative sample of 304 participants, 295 (97%) fully viewed the video, and 94.7% completed follow‐up. At 2 weeks, participants answered 54.4% of questions correctly—only 3.9% (95% confidence interval [CI] =.52–7.3) more than those at 7 weeks. Confidence was poorly correlated with accuracy. Immediate systematic questioning improved later recall by 6.7% (95% CI = 3.3–10.0). A definitive trial of this intervention would require 926 participants. Significance: This is the first evidence on the accuracy of witness recall at clinically relevant intervals. Recall is modest even within recommended timeframes and declines only slightly by 7 weeks. Witness confidence does not predict accuracy. Immediate structured questioning may enhance later recall and thus support seizure diagnoses. [ABSTRACT FROM AUTHOR] |
| Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 190718467 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: How accurate are witnesses of first suspected seizures in recalling semiology at clinically relevant timepoints? A UK experimental study with a pilot intervention. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Noble%2C+Adam+J%2E%22">Noble, Adam J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lane%2C+Steven%22">Lane, Steven</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22New%2C+Paul%22">New, Paul</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cope%2C+Harriet%22">Cope, Harriet</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Foley%2C+Chloe%22">Foley, Chloe</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Williams%2C+Holly+Lynn%22">Williams, Holly Lynn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sztriha%2C+Laszlo%22">Sztriha, Laszlo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Powell%2C+Graham%22">Powell, Graham</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Reuber%2C+Markus%22">Reuber, Markus</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marson%2C+Anthony+G%2E%22">Marson, Anthony G.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Dec2025, Vol. 66 Issue 12, p4795-4808. 14p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Seizures+%28Medicine%29%22">Seizures (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Pilot+projects%22">Pilot projects</searchLink><br /><searchLink fieldCode="DE" term="%22Recollection+%28Psychology%29%22">Recollection (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+errors%22">Diagnostic errors</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: A key diagnostic challenge at "first seizure" clinic appointments is determining whether the reported event was epileptic. Witness accounts are often critical, yet such appointments typically occur weeks after the event. Guidelines recommend review within 2 weeks. Wait times are however often longer, with a median of 7 weeks in countries such as the UK. The accuracy of witness recall at these clinically relevant intervals and whether their confidence predicts accuracy have never been determined. This study addressed these fundamental questions. It also piloted a potential intervention: whether asking witnesses a set of systematic questions immediately after viewing a suspected seizure improves recall at follow‐up, compared to the usual free recall approach used by first responders. Methods: In this UK‐based experimental study, adults (≥18 years old) viewed a video of an epileptic seizure and were randomized into four conditions: A (immediate free recall + 2‐week follow‐up), B (immediate free recall + 7‐week follow‐up), C (immediate systematic questions + 2‐week follow‐up), and D (immediate systematic questions + 7‐week follow‐up). The primary outcome was accuracy on 15 standardized questions addressing key semiological features, scored against consensus ratings from five neurologists. Results: Of a representative sample of 304 participants, 295 (97%) fully viewed the video, and 94.7% completed follow‐up. At 2 weeks, participants answered 54.4% of questions correctly—only 3.9% (95% confidence interval [CI] =.52–7.3) more than those at 7 weeks. Confidence was poorly correlated with accuracy. Immediate systematic questioning improved later recall by 6.7% (95% CI = 3.3–10.0). A definitive trial of this intervention would require 926 participants. Significance: This is the first evidence on the accuracy of witness recall at clinically relevant intervals. Recall is modest even within recommended timeframes and declines only slightly by 7 weeks. Witness confidence does not predict accuracy. Immediate structured questioning may enhance later recall and thus support seizure diagnoses. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=190718467 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/epi.18624 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 14 StartPage: 4795 Subjects: – SubjectFull: Seizures (Medicine) Type: general – SubjectFull: Epilepsy Type: general – SubjectFull: Pilot projects Type: general – SubjectFull: Recollection (Psychology) Type: general – SubjectFull: Clinical trials Type: general – SubjectFull: Diagnostic errors Type: general – SubjectFull: United Kingdom Type: general Titles: – TitleFull: How accurate are witnesses of first suspected seizures in recalling semiology at clinically relevant timepoints? A UK experimental study with a pilot intervention. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Noble, Adam J. – PersonEntity: Name: NameFull: Lane, Steven – PersonEntity: Name: NameFull: New, Paul – PersonEntity: Name: NameFull: Cope, Harriet – PersonEntity: Name: NameFull: Foley, Chloe – PersonEntity: Name: NameFull: Williams, Holly Lynn – PersonEntity: Name: NameFull: Sztriha, Laszlo – PersonEntity: Name: NameFull: Powell, Graham – PersonEntity: Name: NameFull: Reuber, Markus – PersonEntity: Name: NameFull: Marson, Anthony G. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 12 Text: Dec2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 00139580 Numbering: – Type: volume Value: 66 – Type: issue Value: 12 Titles: – TitleFull: Epilepsia (Series 4) Type: main |
| ResultId | 1 |
