Epilepsy is a common condition in the United States. It is estimated that 1.2% of the population or 3.4 million people have epilepsy. This figure may be underestimated because of potential repercussions and stigma in disclosing epilepsy. 1 Studies have shown that people with epilepsy are more likely to be unemployed or unable to work, have lower annual household incomes, be obese and physically inactive, and be less likely to marry. 2,3 People with epilepsy can have poor overall health status, impaired intellectual and physical functioning, elevated risk of accidents and injuries, and negative side effects from antiseizure medications. 2,3 It is estimated the annual direct medical cost of epilepsy in the United States is $9.6 billion; combined with indirect costs, the total rises to $15.5 billion yearly. 2 The American Academy of Neurology (AAN) created standardized quality measures with the overarching goal to improve the delivery of care for patients with epilepsy for providers, practices, and systems. In 2009, the first set of epilepsy measures were released with an update provided in 2014. 4,5 Quality measures are not guidelines; however, they are formed using guidelines, evidence-based medicine, and best practice consensus. Quality measures help us understand how often health care services are provided consistent with current medical knowledge. Measures are updated iteratively to reflect evidence and practice changes, as well as to reflect limitations of data collection and analysis. The AAN reviews each measurement set for updates a minimum of every 3 years. In 2017, the AAN seated a standing multidisciplinary Epilepsy Quality Measurement Set Work Group (work group) charged with updating the measurement set. This work group will revisit the epilepsy measures every 6 months, evaluating new evidence statements and new measures released by other developers. As part of this process, epilepsy measure implementation and performance data review will also occur to nimbly respond to emerging guidelines and evidence. During this initial review, the work group evaluated new evidence, 2014 epilepsy measure use data, and other new measures released by other development groups that addressed care for patients with epilepsy, such as the AAN's Child Neurology and Universal Neurology Quality Measure projects. The work group approved 6 measures and retired 6 measures from the 2014 update (table 1). Measure retirement occurs if evidence has changed, a gap in performance no longer exists, feasibility concerns exist, or significant edits are needed to the existing measure. It does not mean the topic is no longer important.
