{"doi":"10.1002/acn3.52146","title":"An ordinal clinical score predicts seizure freedom after minimally invasive epilepsy surgery","abstract":"OBJECTIVE: To predict one-year seizure freedom, using a combination of relevant clinical variables, following stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy in a series of 101 patients. METHODS: Eight predictors of seizure freedom were selected based on their association with medial temporal lobe epilepsy: (1) MRI evidence of mesial temporal sclerosis (MTS); (2) unitemporal interictal epileptiform discharges; (3) absence of generalized tonic-clonic seizures; (4) history of febrile seizures; (5) onset of epilepsy ≤16 years; (6) absence of an auditory, visual, or vertiginous aura; and (7) unitemporal ictal onset; (8) unitemporal PET hypometabolism. We compared four multivariate models: \"MTS,\" using just evidence of MTS; \"FULL,\" using all eight binary predictors; \"AIC\" using backwards selection of variables; and \"SCORE,\" using a 0-to-8-point ordinal score awarding one point for each binary predictor. RESULTS: In univariate analysis, significant predictors for seizure freedom were evidence of mesial temporal sclerosis (p = 0.011, Fisher exact) and unitemporal interictal discharges (p = 0.005). For multivariate prediction (using leave one-out cross-validation), the ordinal SCORE model had a significantly higher area under the curve (AUC 0.70) than the other three models: MTS (AUC 0.54, p = 0.002, Delong's test), FULL (AUC 0.62, p = 0.003), or AIC (AUC 0.53, p < 0.001). INTERPRETATION: An ordinal score incorporating eight independent binary clinical variables predicted seizure freedom better on novel data than a model using MTS alone, a full multivariate model, or a backwards selected model. The ordinal score model represents a simple clinical heuristic to identify which patients should be offered minimally invasive laser surgery.","journal":"Annals of Clinical and Translational Neurology","year":2024,"id":456176,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9563,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":434650,"name":"Katie L. Bullinger","orcid":"0000-0002-2519-7108","position":1,"is_corresponding":false},{"id":967689,"name":"Dayton Grogan","orcid":"0000-0002-9933-5518","position":2,"is_corresponding":false},{"id":1280611,"name":"Melissa M. Asmar","orcid":"0009-0008-0220-0264","position":3,"is_corresponding":false},{"id":696192,"name":"Abdulrahman Alwaki","orcid":null,"position":4,"is_corresponding":false},{"id":392433,"name":"Ammar Kheder","orcid":"0000-0002-3083-8651","position":5,"is_corresponding":false},{"id":110095,"name":"Veeresh Kumar N. Shivamurthy","orcid":"0000-0001-7171-755X","position":6,"is_corresponding":false},{"id":1280612,"name":"Razan Faraj","orcid":"0000-0003-2615-5353","position":7,"is_corresponding":false},{"id":330328,"name":"Alexander Greven","orcid":null,"position":8,"is_corresponding":false},{"id":240422,"name":"Jon T. Willie","orcid":"0000-0001-9565-4338","position":9,"is_corresponding":false},{"id":317070,"name":"Daniel L. Drane","orcid":"0000-0001-8747-672X","position":10,"is_corresponding":false},{"id":227190,"name":"Robert E. Gross","orcid":"0000-0003-1847-9227","position":11,"is_corresponding":false},{"id":695675,"name":"Adam S. Dickey","orcid":"0000-0003-4710-1290","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T02:03:27.785212Z","pmid":"39001603","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}