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This tool estimates the risk of seizure recurrence in patients with generalized tonic-clonic seizures (GTCs) after antiseizure medication (ASM) tapering. The predictions differentiate between patient-initiated and physician-initiated tapering and assess how treatment status (treated vs. untreated) impacts outcomes. The COSY (Chance of an Occurrence of a Seizure in the next Year) field calculates the likelihood of seizure frequency changes within the following year.

Variables Used:

1. Patient-Initiated vs. Physician-Initiated ASM Taper:
   • Determines if ASM discontinuation was guided by a medical professional or undertaken independently by the patient. Physician-guided tapering is associated with a significantly lower risk of recurrence.
2. Treatment Status (Untreated vs. Treated):
   • Indicates whether the patient received treatment with ASMs. Patients who remained untreated experienced a much higher recurrence rate (73%) compared to treated individuals (14%).
3. Slider for Time Points in Months:
   • Allows users to input a specific time duration to calculate the cumulative risk of seizure recurrence at different points.

Outputs:

1. Risk of Seizure Recurrence in % After x Months:
   • Provides the cumulative percentage risk of seizure recurrence based on whether the ASM discontinuation was physician-initiated or patient-initiated.
   • Example: Untreated patients show significantly higher risks, while treated individuals benefit from the structured tapering process.
2. Chance of an Occurrence of a Seizure in the next Year (COSY) in % After x Months:
   • Displays the predicted percentage change in seizure occurrence frequency over the next year, accounting for the type of ASM discontinuation.
   • Predictions are based on data collected up to 72 months.