Epilepsy Centers in United States Expand in Size and Specialized Testing Services with Accreditation

Epilepsy Centers in United States Expand in Size and Specialized Testing Services with Accreditation 150 150 Rebecca Cybulski

Recent data is used to analyze characteristics of accredited epilepsy centers across the United States, including testing, treatment and outcomes for drug resistant epilepsy patients.

New research from the Abigail Wexner Research Institute at Nationwide Children’s Hospital has found that as a result of the increased number of accredited epilepsy centers in the United States, drug-resistant epilepsy (DRE) patients have easier access to specialized testing and services. The report, which describes level 3 and level 4 epilepsy centers that were accredited by the National Association of Epilepsy Centers (NAEC) from 2012 to 2019, published this week in Neurology.

Adam Ostendorf, MD, the director of the Epilepsy Monitoring unit at Nationwide Children’s Hospital, examined the expanse and trends of NAEC-accredited epilepsy centers in the United States from 2012 to 2019. During the study period, growth was seen in various procedure volumes as well as DRE patient access to non-surgical resources.

“This exciting data set showed how epilepsy is managed throughout the United States. It gave insight to the varying resources, services and procedures that DRE patients have access to,” said Dr. Ostendorf. “We can now use this data to better examine disparities in access to epilepsy surgery, as well as study comparative outcomes between centers.”

On an annual basis, the NAEC collects data from accredited epilepsy centers on hospital-based epilepsy monitoring unit (EMU) size and admissions, diagnostic testing, surgeries and other services. Over the course of the study, the number of NAEC-accredited centers increased from 161 to 256. The largest increase in centers across all levels and populations was seen in adult- or pediatric-only centers, with the most increase to access in level 3 and pediatric epilepsy centers. Researchers found the largest growth in procedure volumes occurred in laser interstitial thermal therapy (LITT) (61%), responsive neurostimulation (RNS) implantations (114%) and intracranial monitoring without resection (152%).

When researchers looked at the data, they found the availability of supplemental services and access to advanced diagnostic and therapeutic options increased as epilepsy centers received accreditation.

“In the past, patients have not always had access to various non-surgical resources,” said Dr. Ostendorf. “These resources can include complex testing, alternative or complementary medicine, education of the ketogenic diet and genetic testing and counseling.”

While the current NAEC accreditation process emphasizes structural and process measures of epilepsy center care,  patient outcome data would better incentivize quality care. Addressing  data gaps will help assess the quality of treatment that patients receive across the entire county and furthermore, will help standardize care across health care networks.

“The care received by DRE patients differs across epilepsy centers in the United States,” said Dr. Ostendorf. “This study helped to identify variables, such as the physical location or environment of a NAEC center, that contribute to inconsistent care. Moving forward, it is crucial that we understand how these differences in centers translates to differences in care between patients across the country.”

 

Reference:

Ostendorf AP, Ahrens SM, Lado FA, Arnold ST, Bai S, Bensalem Owen MK, Chapman KE, Clarke DF, Eisner M, Fountain NB, Gray JM, Hopp JL, Riker E, Schuele SU, Small BV, Herman ST. Unites States Epilepsy Center Characteristics: A Data Analysis From the National Association of Epilepsy Centers. American Academy of Neurology. 2022 Feb 1;98(5).

About the author

Rebecca Cybulski is a coordinator for the Social Media and Media Relations teams at Nationwide Children’s Hospital. She is a graduate of Kent State University.