No Cover Image

Journal article 163 views 13 downloads

Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence

Kathryn J Bush, Emer Cullen, Susanna Mills, Richard F M Chin, Rhys H Thomas, Andrew Kingston, Owen Pickrell Orcid Logo, Sheena E Ramsay

The Lancet Public Health, Volume: 9, Issue: 8, Pages: e614 - e628

Swansea University Author: Owen Pickrell Orcid Logo

  • 67280.VoR.pdf

    PDF | Version of Record

    © 2024 The Author(s). This is an Open Access article under the CC BY 4.0 license.

    Download (887.77KB)

Check full text

DOI (Published version): 10.1016/s2468-2667(24)00132-4

Abstract

BackgroundSocioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening i...

Full description

Published in: The Lancet Public Health
ISSN: 2468-2667
Published: Elsevier BV 2024
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa67280
Tags: Add Tag
No Tags, Be the first to tag this record!
first_indexed 2024-08-01T09:24:49Z
last_indexed 2024-08-01T09:24:49Z
id cronfa67280
recordtype SURis
fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>67280</id><entry>2024-08-01</entry><title>Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence</title><swanseaauthors><author><sid>1c3044b5ff7a6552ff5e8c9e3901c807</sid><ORCID>0000-0003-4396-5657</ORCID><firstname>Owen</firstname><surname>Pickrell</surname><name>Owen Pickrell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-08-01</date><deptcode>MEDS</deptcode><abstract>BackgroundSocioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening inequalities, is required. However, the data on UK epilepsy inequalities have not been synthesised in a review and the underlying determinants are unknown.MethodsIn this systematic review and meta-analysis, we searched six bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Scopus) and grey literature published between Jan 1, 1980, and Feb 21, 2024, to identify UK studies reporting epilepsy incidence or epilepsy-related adverse outcomes by socioeconomic factors (individual level or area level). We included longitudinal cohort studies, studies using routinely collected health-care data, cross-sectional studies, and matched cohort studies and excluded conference abstracts and studies not reporting empirical results in the review and meta-analysis. Multiple reviewers (KJB, EC, SER, WOP, and RHT) independently screened studies, KJB extracted data from included studies and a second reviewer (SM or EC) checked data extraction. We used Critical Appraisal Skills Programme checklists to assess quality. We used random-effects meta-analysis to pool incident rate ratios (IRRs) and synthesised results on adverse outcomes narratively. This study was registered on PROPSPERO (CRD42023394143).FindingsWe identified 2471 unique studies from database searches. We included 26 studies, ten of which reported epilepsy incidence and 16 reported epilepsy-related adverse outcomes according to socioeconomic factors. Misclassification, participation, and interpretive biases were identified as study quality limitations. Meta-analyses showed an association between socioeconomic deprivation and epilepsy incidence, with greater risks of epilepsy incidence in groups of high-deprivation (IRR 1·34 [95% CI 1·16–1·56]; I2=85%) and medium-deprivation (IRR 1·23 [95% CI 1·08–1·39]; I2=63%) compared with low-deprivation groups. This association persisted in the studies that only included children (high vs low: IRR 1·36 [95% CI 1·19–1·57]; I2=0%). Only two studies examined factors influencing epilepsy incidence. There is limited evidence regarding UK inequalities in adverse outcomes.InterpretationSocioeconomic inequalities in epilepsy incidence are evident in the UK. To develop an evidence-based public health response to epilepsy, further research is needed to understand the populations affected, factors determining the association, and the extent of inequalities in adverse outcomes.</abstract><type>Journal Article</type><journal>The Lancet Public Health</journal><volume>9</volume><journalNumber>8</journalNumber><paginationStart>e614</paginationStart><paginationEnd>e628</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2468-2667</issnPrint><issnElectronic/><keywords/><publishedDay>1</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-08-01</publishedDate><doi>10.1016/s2468-2667(24)00132-4</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>Epilepsy Research Institute</funders><projectreference/><lastEdited>2024-09-17T13:56:48.8093778</lastEdited><Created>2024-08-01T10:22:33.6531788</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Kathryn J</firstname><surname>Bush</surname><order>1</order></author><author><firstname>Emer</firstname><surname>Cullen</surname><order>2</order></author><author><firstname>Susanna</firstname><surname>Mills</surname><order>3</order></author><author><firstname>Richard F M</firstname><surname>Chin</surname><order>4</order></author><author><firstname>Rhys H</firstname><surname>Thomas</surname><order>5</order></author><author><firstname>Andrew</firstname><surname>Kingston</surname><order>6</order></author><author><firstname>Owen</firstname><surname>Pickrell</surname><orcid>0000-0003-4396-5657</orcid><order>7</order></author><author><firstname>Sheena E</firstname><surname>Ramsay</surname><order>8</order></author></authors><documents><document><filename>67280__31351__89b06e5ea8a34cbfbdecbb660bb82e6e.pdf</filename><originalFilename>67280.VoR.pdf</originalFilename><uploaded>2024-09-17T13:55:20.5185998</uploaded><type>Output</type><contentLength>909073</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2024 The Author(s). This is an Open Access article under the CC BY 4.0 license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/deed.en</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 67280 2024-08-01 Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 2024-08-01 MEDS BackgroundSocioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening inequalities, is required. However, the data on UK epilepsy inequalities have not been synthesised in a review and the underlying determinants are unknown.MethodsIn this systematic review and meta-analysis, we searched six bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Scopus) and grey literature published between Jan 1, 1980, and Feb 21, 2024, to identify UK studies reporting epilepsy incidence or epilepsy-related adverse outcomes by socioeconomic factors (individual level or area level). We included longitudinal cohort studies, studies using routinely collected health-care data, cross-sectional studies, and matched cohort studies and excluded conference abstracts and studies not reporting empirical results in the review and meta-analysis. Multiple reviewers (KJB, EC, SER, WOP, and RHT) independently screened studies, KJB extracted data from included studies and a second reviewer (SM or EC) checked data extraction. We used Critical Appraisal Skills Programme checklists to assess quality. We used random-effects meta-analysis to pool incident rate ratios (IRRs) and synthesised results on adverse outcomes narratively. This study was registered on PROPSPERO (CRD42023394143).FindingsWe identified 2471 unique studies from database searches. We included 26 studies, ten of which reported epilepsy incidence and 16 reported epilepsy-related adverse outcomes according to socioeconomic factors. Misclassification, participation, and interpretive biases were identified as study quality limitations. Meta-analyses showed an association between socioeconomic deprivation and epilepsy incidence, with greater risks of epilepsy incidence in groups of high-deprivation (IRR 1·34 [95% CI 1·16–1·56]; I2=85%) and medium-deprivation (IRR 1·23 [95% CI 1·08–1·39]; I2=63%) compared with low-deprivation groups. This association persisted in the studies that only included children (high vs low: IRR 1·36 [95% CI 1·19–1·57]; I2=0%). Only two studies examined factors influencing epilepsy incidence. There is limited evidence regarding UK inequalities in adverse outcomes.InterpretationSocioeconomic inequalities in epilepsy incidence are evident in the UK. To develop an evidence-based public health response to epilepsy, further research is needed to understand the populations affected, factors determining the association, and the extent of inequalities in adverse outcomes. Journal Article The Lancet Public Health 9 8 e614 e628 Elsevier BV 2468-2667 1 8 2024 2024-08-01 10.1016/s2468-2667(24)00132-4 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee Epilepsy Research Institute 2024-09-17T13:56:48.8093778 2024-08-01T10:22:33.6531788 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Kathryn J Bush 1 Emer Cullen 2 Susanna Mills 3 Richard F M Chin 4 Rhys H Thomas 5 Andrew Kingston 6 Owen Pickrell 0000-0003-4396-5657 7 Sheena E Ramsay 8 67280__31351__89b06e5ea8a34cbfbdecbb660bb82e6e.pdf 67280.VoR.pdf 2024-09-17T13:55:20.5185998 Output 909073 application/pdf Version of Record true © 2024 The Author(s). This is an Open Access article under the CC BY 4.0 license. true eng https://creativecommons.org/licenses/by/4.0/deed.en
title Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
spellingShingle Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
Owen Pickrell
title_short Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
title_full Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
title_fullStr Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
title_full_unstemmed Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
title_sort Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence
author_id_str_mv 1c3044b5ff7a6552ff5e8c9e3901c807
author_id_fullname_str_mv 1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell
author Owen Pickrell
author2 Kathryn J Bush
Emer Cullen
Susanna Mills
Richard F M Chin
Rhys H Thomas
Andrew Kingston
Owen Pickrell
Sheena E Ramsay
format Journal article
container_title The Lancet Public Health
container_volume 9
container_issue 8
container_start_page e614
publishDate 2024
institution Swansea University
issn 2468-2667
doi_str_mv 10.1016/s2468-2667(24)00132-4
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BackgroundSocioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening inequalities, is required. However, the data on UK epilepsy inequalities have not been synthesised in a review and the underlying determinants are unknown.MethodsIn this systematic review and meta-analysis, we searched six bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Scopus) and grey literature published between Jan 1, 1980, and Feb 21, 2024, to identify UK studies reporting epilepsy incidence or epilepsy-related adverse outcomes by socioeconomic factors (individual level or area level). We included longitudinal cohort studies, studies using routinely collected health-care data, cross-sectional studies, and matched cohort studies and excluded conference abstracts and studies not reporting empirical results in the review and meta-analysis. Multiple reviewers (KJB, EC, SER, WOP, and RHT) independently screened studies, KJB extracted data from included studies and a second reviewer (SM or EC) checked data extraction. We used Critical Appraisal Skills Programme checklists to assess quality. We used random-effects meta-analysis to pool incident rate ratios (IRRs) and synthesised results on adverse outcomes narratively. This study was registered on PROPSPERO (CRD42023394143).FindingsWe identified 2471 unique studies from database searches. We included 26 studies, ten of which reported epilepsy incidence and 16 reported epilepsy-related adverse outcomes according to socioeconomic factors. Misclassification, participation, and interpretive biases were identified as study quality limitations. Meta-analyses showed an association between socioeconomic deprivation and epilepsy incidence, with greater risks of epilepsy incidence in groups of high-deprivation (IRR 1·34 [95% CI 1·16–1·56]; I2=85%) and medium-deprivation (IRR 1·23 [95% CI 1·08–1·39]; I2=63%) compared with low-deprivation groups. This association persisted in the studies that only included children (high vs low: IRR 1·36 [95% CI 1·19–1·57]; I2=0%). Only two studies examined factors influencing epilepsy incidence. There is limited evidence regarding UK inequalities in adverse outcomes.InterpretationSocioeconomic inequalities in epilepsy incidence are evident in the UK. To develop an evidence-based public health response to epilepsy, further research is needed to understand the populations affected, factors determining the association, and the extent of inequalities in adverse outcomes.
published_date 2024-08-01T13:56:47Z
_version_ 1810448051008962560
score 11.037603

Similar Items