Quality statement 2: Investigations

Quality statement

Adults having initial investigations for epilepsy undergo the tests within 4 weeks of them being requested.

Rationale

The period between the suspected seizure occurring and diagnosis can be a particularly anxious time for patients and families and it is therefore important that investigations are conducted in a timely manner. The earlier a correct diagnosis of epilepsy is made, the sooner tailored therapy can be initiated. Delays caused by a lack of available diagnostic equipment can lead to distress and impact negatively on the everyday lives of patients.

Quality measure

Structure: Evidence of local arrangements for adults having initial investigations for epilepsy to undergo the tests within 4 weeks of them being requested.

Process: Proportion of adults having initial investigations for epilepsy who undergo the tests within 4 weeks of them being requested.

Numerator – the number of people in the denominator who undergo the tests within 4 weeks of the request.

Denominator – the number of adults having initial investigations for epilepsy.

Outcome: Patient satisfaction with the length of time between tests being arranged and the tests being performed.

What the quality statement means for each audience

Service providers ensure systems are in place for adults having initial investigations for epilepsy to undergo the tests within 4 weeks of them being requested.

Healthcare professionals ensure that adults having initial investigations for epilepsy undergo the tests within 4 weeks of them being requested.

Commissioners ensure they commission services for adults having initial investigations for epilepsy to undergo the tests within 4 weeks of them being requested.

Adults having their first tests for epilepsy have the tests within 4 weeks of them being requested by the doctor.

Source guidance

NICE clinical guideline 137 recommendations 1.6.3 and 1.6.22.

Data source

Structure: Local data collection.

Process: Local data collection.

Outcome: Local data collection.

Definitions

Initial investigations for epilepsy include electroencephalogram (EEG) and magnetic resonance imaging, as appropriate.

Tests such as long-term video or ambulatory EEG, which might be used in the assessment of adults in whom there are difficulties with diagnosis after clinical assessment and standard EEG, might not be possible within this timeframe.

Test results should be interpreted by practitioners who have the necessary competencies.

Information should be provided to adults and families and/or carers as appropriate on the reasons for the tests, their results and meaning, the requirements of specific investigations, and the logistics of obtaining them.

Equality and diversity considerations

Adults with learning disabilities or challenging behaviour might need particular care and attention to help them tolerate investigations. The same services and investigations should be offered to adults with learning disabilities as are offered to the general population.