Evaluating the Effectiveness and Cost-Effectiveness of Seizure Dogs in Persons With Medically Refractory Epilepsy in the Netherlands: Study Protocol for a Stepped Wedge Randomized Controlled Trial (EPISODE)

Wester, Valérie; Groot, Saskia de; Kanters, Tim A.; Wagner, Louis; Ardesch, J.J.; Ramos, Isaac Corro; Enders-Slegers, Marie-José; Ruiter, M. de; Cessie, Saskia le; Los, Jeanine; Papageorgiou, Grigorios; Exel, Job van; Versteegh, Matthijs

doi:10.3389/fneur.2020.00003

Cited by 7 publications

(14 citation statements)

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“…This article reports findings of a secondary analysis on data collected for a (cost-) effectiveness study, and, therefore, power calculations were not performed for the current analyses. 15 Hence, this study should be considered as explorative. Nonetheless, the sensitivity analyses that were conducted confirm the results regarding the impact of seizure count on the day of completing EQ-5D on HRQoL estimates.…”

Section: Discussionmentioning

confidence: 99%

“…Data from the Epilepsy Support Dog Evaluation (EPISODE) study were used. 15 The EPISODE study is a stepped-wedge randomized controlled trial that evaluates the effectiveness and cost-effectiveness of seizure dogs in people with medically refractory epilepsy. Seizure dogs are trained to detect seizures and to respond during or immediately after a seizure.…”

Section: Data Sourcementioning

confidence: 99%

“…More details on the rationale and design of the study are described in the study protocol. 15 In the EPISODE study, seizure frequency is measured using a seizure diary. PWE record the daily seizure count per seizure type in a paper diary, of which they upload a photograph every week via a mobile phone application.…”

Section: Data Sourcementioning

confidence: 99%

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Good Days and Bad Days: Measuring Health-Related Quality of Life in People With Epilepsy

et al. 2021

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Objectives: Cost-effectiveness analyses typically require measurement of health-related quality of life (HRQoL) to estimate quality-adjusted life-years. Challenges with measuring HRQoL arise in the context of episodic conditions if patients are less likely-or even unable-to complete surveys when having disease symptoms. This article explored whether HRQoL measured at regular time intervals adequately reflects the HRQoL of people with epilepsy (PWE).Methods: Follow-up data from the Epilepsy Support Dog Evaluation study on the (cost-)effectiveness of seizure dogs were used in which HRQoL is measured in 25 PWE with the EQ-5D at baseline and every 3 months thereafter. Seizure count is recorded daily using a seizure diary. Regression models were employed to explore whether PWE were more likely to complete the HRQoL survey on a good day (ie, when seizures are absent or low in frequency compared with other days) and to provide an estimate of the impact of reporting HRQoL on a good day on EQ-5D utility scores.Results: A total of 111 HRQoL measurements were included in the analyses. Regression analyses indicated that the day of reporting HRQoL was associated with a lower seizure count (P,.05) and that a lower seizure count was associated with a higher EQ-5D utility score (P,.05).Conclusions: When HRQoL is measured at regular time intervals, PWE seem more likely to complete these surveys on good days. Consequently, HRQoL might be overestimated in this population. This could lead to underestimation of the effectiveness of treatment and to biased estimates of cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

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Good Days and Bad Days: Measuring Health-Related Quality of Life in People With Epilepsy

et al. 2021

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“…To our knowledge, this was the first attempt to analyse the cost-effectiveness of having a physical service dog or a diabetes alert dog, and further research is in the pipeline. Wester et al have recently published a study protocol with the intention to study the cost-effectiveness of seizure dogs for people with medically refractory epilepsy in the Netherlands [101].…”

Section: The Value Of Using Dogs As Assistive Aids and In Healthcarementioning

confidence: 99%

Health Technology Assessment of Assistance Dogs and Dog-Assisted Interventions

Lundqvist

2020

Linköping University Medical Dissertations

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Dogs as an assistive aid for people with disabilities date as far back in time as the first century CE. Today, dogs are used in various settings to help and assist humans. 'Assistance dogs' is an umbrella term for guide dogs, hearing dogs and service dogs. They are custom trained to help and support their owners in their everyday life and thereby give them greater independence. Dogs who perform dog-assisted interventions are another type of working dog, where the dog and the owner work together as a team visiting people with various needs in different settings such as hospitals and nursing homes. These visits aim to strengthen people's inner motivation, using the dog as an external motivator. There is a lack of evaluations of working dogs in the health technology assessment context, and in the health economic evaluation context. Hence, there is a need for structured analyses that include both the short-and long-term effects and the costs of assistance dogs and dog-assisted interventions.The overall aim of this thesis is to explore and assess the use of assistance dogs and dog-assisted interventions.The research questions were investigated using a variety of methods. In paper I, inferential statistical analysis was used to analyse patient-reported outcomes measures. In paper II, a thematic content analysis was employed to explore the experiences of service and hearing dogs. To study the long-term cost-effectiveness of physical service dogs and diabetes alert dogs, a decision analytic model was used in paper III. The input data in studies I, II, and III was obtained from the Service and Hearing Dog Project. In paper III, the data was also supplemented with information from published literature and expert opinions. Paper IV investigated the effects and cost-effectiveness of dog-assisted interventions, and takes the form of a systematic review.Paper I showed that a service or hearing dog have positive impact on its owner's health-related quality of life, well-being and activity level. Paper II showed that owners of service or hearing dogs experienced both positive physical and psychosocial effects from their dog. Negative experiences were also identified, for example being denied access to public places and negative attitudes from other people. Paper III showed that physical service dogs and diabetes alert dogs are cost-effective in comparison with regular companion dogs, resulting in both lower costs and a gain in QALYs. The one-way sensitivity analysis did not change the results, but the probabilistic sensitivity analysis showed that the results were uncertain. Synthesizing Lars-Åke Levin, my supervisor, for generously sharing your great knowledge and experiences. For all the time you put into reading my work and guiding me forward. Your encouragement and praise have made me grow, both professionally and personally. Jenny Alwin, my co-supervisor, for being genuinely supportive and for teaching me the importance of being accurate and transparent. Your door has always been open, and you have always shown great confid...

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“…Perhaps the best known of these dogs is the guide dog for humans with a visual disability. Other examples include dogs for those with a hearing impairment [ 5 ], dogs that detect low blood sugar [ 6 ], dogs that detect symptoms of epileptic seizure [ 7 ], dogs that assist with a physical disability [ 8 ], dogs that assist with autism spectrum disorder (ASD) [ 9 , 10 ], and dogs that assist those with a post-traumatic stress disorder (PTSD) [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Do Service Dogs for Veterans with PTSD Mount a Cortisol Response in Response to Training?

Houtert

Endenburg

Rodenburg

et al. 2021

Animals

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Only a few studies have investigated the welfare of animals participating in animal-assisted interventions (AAIs). Most of these studies focus on dogs in therapeutic settings. There are, however, also dogs—service dogs—that are employed to continuously support a single human. Because the welfare of these service dogs is important for the sustainability of their role, the aim of this study was to investigate their stress response to service dog training sessions. To do this, we took repeated salivary cortisol samples from dogs who participated in a training session (n = 19). Samples were taken just after arrival at the training ground, before training, after training, and after a period of free play. Our results showed that mean cortisol levels in all samples were relatively low (between 1.55 ± 1.10 and 2.73 ± 1.47 nmol/L) compared to similar studies. Analysis further showed that samples taken before and after participation in the training’s session did not differ from one another. Mean cortisol levels in both situations were additionally lower than those upon arrival at the training site and after a period of free play. This led to the conclusion that the dogs in our study did not seem to experience training as stressful.

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Evaluating the Effectiveness and Cost-Effectiveness of Seizure Dogs in Persons With Medically Refractory Epilepsy in the Netherlands: Study Protocol for a Stepped Wedge Randomized Controlled Trial (EPISODE)

Cited by 7 publications

References 59 publications

Good Days and Bad Days: Measuring Health-Related Quality of Life in People With Epilepsy

Good Days and Bad Days: Measuring Health-Related Quality of Life in People With Epilepsy

Health Technology Assessment of Assistance Dogs and Dog-Assisted Interventions

Do Service Dogs for Veterans with PTSD Mount a Cortisol Response in Response to Training?

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