Researcher makes the case for GASE

Assessing the ongoing severity of epilepsy in children may be as simple as a single question, said a recent Western grad.

The Global Assessment of Severity of Epilepsy (GASE) scale, born at Western almost a decade ago, is a single-item, seven-point global rating scale designed for neurologists to report overall severity of epilepsy in children.

Cindy Chan, who graduated early this year with her Masters from the Department of Epidemiology & Biostatistics, said the severity of epilepsy has been assessed predominantly with measures of the severity of seizures. But these measures fail to address other dimensions of epilepsy, such as disability caused by disease, side effects of antiepileptic drugs, seizure frequency and impact on daily life activities.

Seizure severity alone also fails to provide a complete clinical representation of the severity of the patient’s condition, she added.

Chan was interested in finding out if the measurement properties of the GASE scale would still be accurate in its reliability and responsiveness to any change in the severity of epilepsy over a period of time.

Under Western professor Kathy Speechley, who was involved in the initial Health-Related Quality of Life in Children with Epilepsy Study that created the GASE scale, Chan said the assessment tool continued its reliability.

“We were able to show there was a strong, or moderate, relationship with the severity of frequency, intensity of seizures; a lot of the important clinical aspects that clinicians look at when assessing severity,” said Chan, who now works for an epilepsy research organization at the University of Toronto. “Also, 12 months down the road, and even two years later, it was still able to pick up some changes too.”

The GASE scale asks clinicians ‘Taking into account all aspects of this patients’ epilepsy, how would you rate its severity now?’ with a seven-point scale ranging from not at all severe to extremely severe.

Chan said GASE remains a comprehensive tool in measuring of the ongoing severity and multifaceted dimensions of someone with epilepsy, which is important to clinicians and their patients.

“It was exciting to see that it could detect change in these patients,” Chan said. “It’s like another tool clinicians can use to detect a bigger picture of patients with epilepsy, rather than just focusing on the severity of seizures. They have another option to add to all the tools they can use now, which can help with treatment and decisions.”