A modified Delphi study to determine the contents of a seizure diary for patients living with epilepsy in South Africa

BACKGROUND: Epilepsy is a debilitating chronic medical condition affecting many patients globally. A seizure diary is used in monitoring and managing patients with epilepsy. In South Africa, no standardized diary is currently being used. OBJECTIVE: This study intended to develop a consensus among experts managing patients with epilepsy on the content of a seizure diary. METHODS: The modified Delphi method consisted of three survey rounds spanning six months. Using a three-point Likert scale questionnaire, in round one, the panelists were required to choose an option (definitely required, optional, and not required) for 50 items and comment on the contents of the diary. In round two, three items were added based on comments from the panelists. In round three, panelists were allowed to deliberate further on unresolved items and change their responses in view of the group responses. The consensus was determined as an a priori threshold of >70% on items definitely required, optional, or not required. RESULTS: Eleven local and two international panelists were enrolled in this study. Twelve completed all three rounds. The consensus was achieved in 21 of 50 items in round 1, three of seven items in round 2, and one of two items in round 3, of which 18 were definitely required as contents of a seizure diary. CONCLUSIONS: Based on expert opinions, the modified Delphi study determined the essential contents of a seizure diary for use by patients with epilepsy in South Africa.