RT Journal
A1 Engel J, McDermott MP, Langfitt JT
T1 TReatment of refractory mesial temporal lobe epilepsy—reply
JF JAMA
JO JAMA
YR 2012
FD June 20
VO 307
IS 23
SP 2483
OP 2485
DO 10.1001/jama.2012.4991
UL http://dx.doi.org/10.1001/jama.2012.4991
AB 
In Reply:  We appreciate the concern of Dr Kieling and colleagues regarding the small number of participants in ERSET. Our original plan was to make HRQOL the primary outcome measure, but we changed this to seizure freedom at the request of the National Institutes of Health review panel prior to approval for funding. Nevertheless, we believe our data support a benefit of surgery on HRQOL. Although the effect at 24 months did not reach statistical significance based on the primary intention-to-treat analysis (P = .08), significant differences were found at all earlier time points (P < .009) and at 24 months when postsurgery data from participants in the medical group who received surgery were excluded. The observed effects on secondary outcomes such as driving and socialization further justify a conclusion that early surgery results in psychosocial benefits relative to continued medical management.