Epilepsy Incidence Among Children in the United States

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Few population-based epilepsy incidence studies among children in the United States exist, and these studies are limited to specific geographic areas with small sample sizes. Studies which used nationwide administrative and claims data to estimate epilepsy incidence among children were conducted more than a decade ago and failed to provide national generalizability due to their limited data sources. This NOFO will contribute to a comprehensive understanding of epilepsy incidence (any type), incident-related risk factors, and incidence disparities among the general U.S. pediatric population or subpopulations. The knowledge obtained from this study will assist health officials shape public health policies by allocating resources, planning for healthcare services, and implementing preventive measures. The objectives of the NOFO are to: (1) Estimate epilepsy incidence among U.S. children 0 - 17 years of age based upon a study with comprehensive nationwide dataset(s), or a population-based study at a specific level(s) (e.g., national, regional, jurisdictional); (2) Identify factors that contribute to the risk of developing epilepsy, and examine the association between these risk factors and incidence; and (3) Examine potential disparities in incidence rates of epilepsy stratified by demographic, geographical, the social determinants of health (SDOH), or other characteristics. The target population is for U.S. children aged 0 - 17 years, and for the study of certain epilepsies, some age ranges within 0 - 17 years are acceptable. Additionally, this study should include a nationally representative sample of age, sex, race/ethnicity, and social strata, and include subgroups which allow an examination of risk factors and SDOH. The applicant is expected to: (1) Conduct a retrospective study using public/commercial administrative and/or claims data, electronic health records, or survey data; (2) Ensure dataset(s) have sufficient sample sizes relative to risk factors, allowing incidence rates to be stratified by these factors. If public/commercial claims data or survey data are used, it should include child populations from all states and Washington DC. Examples of claims data are Marketscan and Medicaid. If EHR data are used, adequate details/justification must be included; (3) Identify risk factors based on the literature. Risk factors may be children-specific (e.g., prenatal, perinatal, or neonatal factors), children non-specific (e.g., comorbidities, demographic, SDOH factors), and/or other factors; and (4) Propose a research team with expertise in epidemiological methods, analytical skills, and pediatric epilepsy diagnosis and treatment.