Commentary: Dr John Brownlee MA, MD, DSc, DPH (Cantab), FRFPS, FSS, FRMetS (1868-1927), public health officer, geneticist, epidemiologist and medical statistician.

In July 1914 Dr John Brownlee was appointed head of the Statistical Department of the newly established Medical Research Committee. He had qualified in mathematics, natural philosophy and medicine at the University of Glasgow, and by 1914 had established a reputation as a public health officer, an expert in infectious diseases, and as a proponent of the Pearsonian school of the application of statistics and mathematics to medicine: an ideal background for his new position. In celebration of the centenary anniversary of the Medical Research Council and as a tribute to John Brownlee's involvement at the start, the International Journal of Epidemiology is reprinting in this issue one of his early papers on genetics. We comment on this paper, as well as Brownlee's background, achievements, research and his somewhat enigmatic though likeable character.

Prediction of risk of seizure recurrence after a single seizure and early epilepsy: further results from the MESS trial.

BACKGROUND: The MRC Multicentre trial for Early Epilepsy and Single Seizures (MESS) showed a reduced risk of further seizures in patients, for whom treatment with antiepileptic drugs was uncertain, who were randomly assigned immediate treatment compared with delayed treatment. However, there was no evidence of an effect on [corrected] long-term remission rates. This study was undertaken to assess the role of patient characteristics and treatment in the prediction of seizure recurrence. This will enable decision-making on the basis of the perceived risk of treatment compared with the benefit of reducing the risk of further seizures in the initial years after diagnosis. METHODS: A prognostic model was developed based on individual patient data from MESS to enable identification of patients at low, medium, or high risk of seizure recurrence. A split-sample approach was used in which the model was developed on a subsample of the full data and validated on the remainder of the sample. Distinction of the prognostic groups and predictive accuracy of the model were assessed. FINDINGS: Number of seizures of all types at presentation, presence of a neurological disorder, and an abnormal electroencephalogram (EEG) were significant factors in indicating future seizures. Individuals with two or three seizures, a neurological disorder, or an abnormal EEG were identified as the medium-risk group, those with two of these features or more than three seizures as the high-risk group, and those with a single seizure only as the low-risk group. INTERPRETATION: The model shows that there is little benefit to immediate treatment in patients at low risk of seizure recurrence, but potentially worthwhile benefits are seen in those at medium and high risk.