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Jelmoni AJ, Cannizzaro D, Uralov D, Totis F, Safa A, Zaed I, Fauzi AA, Khan T, Esene IN, Kolias A, Karekezi C, Hutchinson P, Servadei F. Collaborative Initiatives in Neurosurgery Research and Publications Between High-Income and Low/Middle-Income Countries: A Bibliometric Analysis. Neurosurgery 2024; 95:e121-e131. [PMID: 39283118 PMCID: PMC11377094 DOI: 10.1227/neu.0000000000002935] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/01/2024] [Indexed: 09/22/2024] Open
Abstract
Despite the globalization of health information, collaborations between high-income countries (HICs) and low/middle-income countries (LMICs), while present, could still increase. This study builds on previous research highlighting LMIC underrepresentation in neurosurgery literature. We conducted a comprehensive bibliometric analysis using the Scopus database to investigate collaborative neurosurgical research between HIC institutions and those in low-income country (LIC)/LMICs. Articles published between 2018 and 2020 were examined. Articles were categorized into 3 groups: guidelines, conferences, and consensus statements; articles related to training and collaborations; and other articles. We categorized articles and authors by country, role, and specific subtopic. We included 238 reports from 34 neurosurgical journals for analysis. Geographic distribution indicated that India led LIC/LMIC contributions (25.21%). Among HICs, the United States had the highest contribution (47.76%). In collaborative studies, Uganda, Cameroon, Tanzania, Indonesia, and Nigeria made significant contributions. LICs and LMICs accounted for 446 authors, while HICs contributed with 592. India has presented the highest number of authors in significant positions. In HICs, significant positions are recognized in USA articles. When scoring authors' position in collaborative papers, still HICs had a clear prevalence. The highest number of collaborations between HICs and LICs/LMICs has been observed in articles related to training and collaborations. Kenya matched India's contributions in training and collaborations. Global guidelines and consensus papers can enhance patient care, but LMICs' involvement remains limited. Further attention to training and collaboration initiatives is needed. This study emphasizes the importance of promoting collaboration and training between countries with varying resources to advance neurosurgical care globally.
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Affiliation(s)
| | - Delia Cannizzaro
- Neurosurgical Unit, Department of Neurosciences, ASST Ovest Milanese - Legnano Hospital, Legnano, Italy
| | - Daniel Uralov
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Francesca Totis
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Adrian Safa
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, EOC, Lugano, Switzerland
| | - Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Tariq Khan
- Department of Neurosurgery, North Western General and Research Hospital, Peshawar, Pakistan
| | - Ignatius N Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Angelos Kolias
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, University of Rwanda, Kigali, Rwanda
| | - Peter Hutchinson
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Franco Servadei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
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Haizel-Cobbina J, Balogun JA, Park KB, Haglund MM, Dempsey RJ, Dewan MC. An Overview of Global Neurosurgery. Neurosurg Clin N Am 2024; 35:389-400. [PMID: 39244311 DOI: 10.1016/j.nec.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Until recently, surgery had been passed over in the domain of global health, historically being described as "the neglected stepchild of global health." Knowledge of the existing global disparities in neurosurgical care has led to neurosurgery capacity-building efforts especially in low-income and middle-income countries. While many global collaborative projects are currently undertaken with philanthropic support, sustainability and scalability are not likely without governmental adoption of neurosurgery-inclusive national surgical plans. Momentum grows for the global neurosurgery community to develop a global neurosurgery action plan outlining goals, a guiding framework, an execution plan, and indicators for monitoring and evaluation.
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Affiliation(s)
- Joseline Haizel-Cobbina
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James A Balogun
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard University, Boston, MA, USA
| | - Michael M Haglund
- Department of Neurosurgery, Division of Global Neurosurgery and Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Robert J Dempsey
- Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Michael C Dewan
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.
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Garcia RM, Shlobin NA, Baticulon RE, Ghotme KA, Lippa L, Borba LA, Qureshi M, Thango N, Khan T, Hutchinson P, Rosseau G. Global Neurosurgery: An Overview. Neurosurgery 2024; 95:501-508. [PMID: 39145649 DOI: 10.1227/neu.0000000000003109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/21/2024] [Indexed: 08/16/2024] Open
Abstract
In the following article, we define the practice of global neurosurgery and review the major historical events defining this movement within the larger context of global surgery. The current state of the neurosurgical workforce, disease burden, and ongoing collaborative efforts are highlighted. Ethical practice leading the sustainability is discussed, as well as future targets for the global community as we look beyond the next decade of opportunities to affect the neurosurgical burden of disease.
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Affiliation(s)
- Roxanna M Garcia
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois, USA
| | - Nathan A Shlobin
- McGaw School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Kemel A Ghotme
- Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia
- Pediatric Neurosurgery, Department of Neurosurgery, Fundacion Santa Fe de Bogota & Universidad de La Sabana, Chía, Colombia
| | - Laura Lippa
- Department of Neurosurgery, ASST, Ospedale Maggiore Niguarda, Milan, Italy
| | - Luis A Borba
- Federal University of Parana, Curitiba, Parana, Brazil
| | | | - Nqobile Thango
- Division of Neurosurgery, Neuroscience Institute, University of Cape Town, Red Cross Children's Hospital, Cape Town, South Africa
| | - Tariq Khan
- Northwest School of Medicine, Peshawar, Pakistan
| | - Peter Hutchinson
- Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Barrow Neurological Institute, Phoenix, Arizona, USA
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Shakir M, Khowaja AH, Shariq SF, Irshad HA, Tahir I, Rae AI, Hamzah R, Gupta S, Park KB, Enam SA. Workforce Challenges for the Neurosurgical Care of Brain Tumors in Low- and Middle-Income Countries: A Scoping Review. World Neurosurg 2024; 189:387-398.e3. [PMID: 38925244 DOI: 10.1016/j.wneu.2024.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
Limited neurosurgical workforces remain one of the critical problems experienced in low resource settings. Therefore, our study aims to explore and summarize the key challenges to neurosurgical care of brain tumors in terms of workforce in LMICs. A comprehensive literature search was conducted using Scopus, PubMed, CINAHL, and Google Scholar from inception to October 20, 2022. All extracted data were screened independently by 2 reviewers and thematically analyzed. We found and screened 3764 articles, of which 33 studies were included in our final analysis as per our inclusion criteria. Among the studies included, 33% highlighted the limited number of neurosurgeons, 39% emphasized the absence of specialized surgical teams, 7% pointed out a shortage of nursing staff, and 4% noted suboptimal anesthesia teams. The study uncovered the need for improved training programs in neuro-oncology (32%) and neuro-anesthesia (3%), as well as improved collaboration (32%), and multidisciplinary team structures (15%), are essential for tackling these workforce challenges and improving patient outcomes. It is crucial to implement targeted interventions and policy changes to address the barriers to the workforce in providing effective neurosurgical care to patients with brain tumors in developing countries. This might entail capacity building and training programs for healthcare professionals. Policymakers should consider allocating resources and funding for workforce development and making neurosurgical care a priority in healthcare plans.
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Affiliation(s)
- Muhammad Shakir
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | | | | | | | - Izza Tahir
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Ali I Rae
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Radzi Hamzah
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Saksham Gupta
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Kee B Park
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Syed Ather Enam
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
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Abdelwahab SI, Elhassan Taha MM, Duarte AE, Jan M, Hassan W. The Neurosurgical Research Progress of 98 Low and Lower Middle-Income Countries from 1928 to 2024. World Neurosurg 2024; 189:e977-e992. [PMID: 38996964 DOI: 10.1016/j.wneu.2024.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/05/2024] [Accepted: 07/06/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE The aim of the present study was to analyze the trends of neurosurgical research in low and lower middle-income countries (LLMICs). METHODS The data was retrieved from Scopus database and 82 neurosurgical journals were analyzed. RESULTS Initially the global research scholarly output (n = 195,658) was explored and later papers originating solely from LLMICs, without international collaboration with advance countries (n = 8408) were analyzed. The per decade number of publications (from 1920 to May 2024), top ten authors, universities, countries and sources of all (global) countries, and 98 LLMICs is provided. Eighty countries have published less than 50 papers. Even more striking, 68, 55, 38, and 36 LLMICs countries have produced less than 20, 10, 5, and 3 papers, respectively. The keywords analysis was performed to present the main focus of 8408 publications. The top 1000 most cited documents were also identified, and later relevant scientometrics details were provided. The top countries dynamic and most prolific authors (on the basis of number of publications, total citations, h-index, g-index, and m-index) in the top 1000 cited documents (from LLMICs) are highlighted. CONCLUSIONS The findings suggest that neurosurgical research in LLMICs is low, which could be attributed to several factors including limited funding, inadequate infrastructure, and insufficient training opportunities.
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Affiliation(s)
| | | | | | - Maryam Jan
- Institute of Chemical Sciences, University of Peshawar, Peshawar, Pakistan
| | - Waseem Hassan
- Institute of Chemical Sciences, University of Peshawar, Peshawar, Pakistan.
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Baticulon RE, Dewan MC, Karekezi C, Shlobin NA, Garcia RM, Ghotme KA, Thango N, Rosseau G, Hutchinson PJ. Achieving Equity Through Global Neurosurgery Research. Neurosurgery 2024:00006123-990000000-01319. [PMID: 39185879 DOI: 10.1227/neu.0000000000003107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/13/2024] [Indexed: 08/27/2024] Open
Abstract
Since the release of the Lancet Commission on Global Surgery report in 2015, there has been an increase in the number of published papers on global neurosurgery, gaining widespread support from major neurosurgery journals. However, there remains no consensus on what may be considered part of global neurosurgery literature. Here, we propose that global neurosurgery research encompasses all scholarly work that measure, explore, or address inequity in the care of neurosurgical disease. We describe the growth of global neurosurgery research, cite landmark papers, and discuss barriers to participation, particularly among neurosurgeons in low- and middle-income countries. We introduce the 3Rs framework, advocating for global neurosurgery research that is rigorous, responsive, and responsible. This narrative review aims to guide young neurosurgeons and other researchers interested in the field, and to provide a framework through which global neurosurgery practitioners and advocates can evaluate previously accomplished work, paving the way toward neurosurgery that is timely, safe, and affordable to all.
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Affiliation(s)
- Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Michael C Dewan
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, University of Rwanda, Kigali, Rwanda
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Roxanna M Garcia
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kemel A Ghotme
- Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia
- Neurosurgery Department, Fundacion Santa Fe De Bogota, Bogota, Colombia
| | - Nqobile Thango
- Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Peter J Hutchinson
- NIHR Global Health Research Group on Neurotrauma, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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7
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Muchai E, Lukwesa F, Aganze JM, Kuol PP, Mittal G, Emhemed MS, Phiri EC, Adrien TDE. The Field of Neurosurgery in Kenya: Challenges Faced by Early Career Researchers and Recommendations. Neurosurg Rev 2024; 47:480. [PMID: 39186072 DOI: 10.1007/s10143-024-02672-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 07/22/2024] [Accepted: 08/09/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Emmanuel Muchai
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- College of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Fanwell Lukwesa
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- School of Medicine, The Copperbelt University, Kitwe, Zambia
| | - Josué Mwambali Aganze
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Piel Panther Kuol
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Department of Medicine and Surgery, University School of Medicine, Eldoret, Kenya
| | - Gaurav Mittal
- Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
| | - Marwa SaedAli Emhemed
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Emmanuel Chileshe Phiri
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- School of Medicine, The Copperbelt University, Ndola, Zambia
| | - Tangmi Djabo Eric Adrien
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon.
- Faculty of Medicine, Université Technologique Bel Campus, Kinshasa, Democratic Republic of Congo.
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Oliveira Júnior ALF, Oliveira JVMP, Kolias AG, Paiva WS, Fontoura Solla DJ. False claims of equivalence in the neurosurgical trauma literature: prevalence and associated factors-a systematic review protocol. BMJ Open 2024; 14:e044794. [PMID: 39079923 PMCID: PMC11293374 DOI: 10.1136/bmjopen-2020-044794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/23/2021] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Research quality within the neurosurgical field remains suboptimal. Therefore, many studies published in the neurosurgical literature lack enough statistical power to establish the presence or absence of clinically important differences between treatment arms. The field of neurotrauma deals with additional challenges, with fewer financial incentives and restricted resources in low-income and middle-income countries with the highest burden of neurotrauma diseases. In this systematic review, we aim to estimate the prevalence of false claims of equivalence in the neurosurgical trauma literature and identify its predictive factors. METHODS AND ANALYSIS The Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations were followed. Randomised clinical trials that enrolled only traumatic brain injury patients and investigated any type of intervention (surgical or non-surgical) will be eligible for inclusion. The MEDLINE/PubMed database will be searched for articles in English published from January 1960 to July 2020 in 15 top-ranked journals. A false claim of equivalence will be identified by insufficient power to detect a clinically meaningful effect: for categorical outcomes, a difference of at least 25% and 50%, and for continuous outcomes, a Cohen's d of at least 0.5 and 0.8. Using the number of patients in each treatment arm and the minimum effect sizes to be detected, the power of each study will be calculated with the assumption of a two-tailed alpha that equals 0.05. Standardised differences between the groups with and without a false claim of equivalence will be calculated, and the variables with a standardised difference equal or above 0.2 and 0.5 will be considered weakly and strongly associated with false claims of equivalence, respectively. The data analysis will be blinded to the authors and institutions of the studies. ETHICS AND DISSEMINATION This study will not involve primary data collection. Therefore, formal ethical approval will not be required. The final systematic review will be published in a peer-reviewed journal and presented at appropriate conferences.
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Affiliation(s)
| | | | - Angelos G Kolias
- Division of Neurosurgery, University of Cambridge, Cambridge, UK
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9
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Young T, Tropeano MP, Cannizzaro D, Jelmoni AJM, Servadei F, Germano IM. The Current Landscape of Neurosurgical Oncology in Low-Middle-Income Countries (LMIC): Strategies for the Path Forward. World Neurosurg 2024; 184:e291-e298. [PMID: 38286320 DOI: 10.1016/j.wneu.2024.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To promote global equity in research, innovation, and care, sharing knowledge and grasping current benchmarks is crucial. Despite LIC/LMIC constituting around 80% of the global population, their contribution to neurosurgery research is less than 5%. This study aims to assess the status of neurosurgical oncology in LIC/LMIC using published data, offering strategic insights for progress. METHODS Conducting a retrospective bibliometric analysis via PubMed and Scopus databases, we documented reports published (2015-2021) by neurosurgical department-affiliated investigators in LICs/LMICs. World Bank classifications identified LIC and LMIC. Reviewed papers underwent further scrutiny based on independent and associated keyword lists. RESULTS Our systematic approach revealed 189 studies from LMIC in 10 neurosurgery journals. Of these, 53% were case reports, with 88% focusing on brain pathologies and 12% on the spine. Intra-axial brain tumors (45.8%), extra-axial/skull base (38.4%), and metastasis (3.68%) were prominent. Among noncase report publications, surgical technique and outcome were common themes. India, Egypt, and Tunisia led in publications, with 94% appearing in journals with an impact factor below 5. No papers originated from LIC. CONCLUSIONS This study reinforces existing findings that data from LMIC inadequately represent their populations, impeding a comprehensive understanding of their neurosurgical oncology landscape. Language barriers and data collection difficulties contribute to this gap. Addressing these challenges could significantly enhance progress in shaping the future of neurosurgical oncology in these regions.
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Affiliation(s)
- Tirone Young
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria Pia Tropeano
- Neurosurgical Unit, Department of Neurosciences, ASST Ovest Milanese - Legnano Hospital, Milan, Italy
| | - Delia Cannizzaro
- Neurosurgical Unit, Department of Neurosciences, ASST Ovest Milanese - Legnano Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Alice J M Jelmoni
- Neurosurgical Unit, Department of Neurosciences, ASST Ovest Milanese - Legnano Hospital, Milan, Italy
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University, Milano, Italy
| | - Isabelle M Germano
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Jalloh M, Kankam SB, Okon II, Zeto R. Fostering neurosurgery research in low- and middle-income countries: the role of international collaboration. Neurosurg Rev 2024; 47:128. [PMID: 38528260 DOI: 10.1007/s10143-024-02357-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Mohamed Jalloh
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Samuel Berchi Kankam
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
- Harvard T.H Chan School of Public Health, Harvard University, Cambridge, USA.
| | - Inibehe Ime Okon
- Department of Neurosurgery, Evoke Neurosurgery (ENS), Bukavu, DR, Congo
| | - Ruth Zeto
- Harvard T.H Chan School of Public Health, Harvard University, Cambridge, USA
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11
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Long YR, Zhao K, Zhang FC, Li Y, Wang JW, Niu HQ, Lei J. Trends and hotspots in research of traumatic brain injury from 2000 to 2022: A bibliometric study. Neurochem Int 2024; 172:105646. [PMID: 38061405 DOI: 10.1016/j.neuint.2023.105646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/01/2024]
Abstract
Traumatic brain injury (TBI) is a major health concern globally, which is characterized by high morbidity and mortality rates. Since the 21st century, TBI has received increasing attention and the number of publications is growing rapidly. This study aimed to characterize the volume and quality of scholarly output on TBI and identify the most impactful literature, research trends, and hotspots from the year 2000-2022. We searched publications on TBI through the Web of Science Core Collection-Science Citation Index Expanded database which were published from 2000 to 2022. Basic information of each paper, including publication year, countries, authors, affiliations, journal, fundings, subject areas, and keywords were collected for further analysis by using Microsoft Excel, VOSviewer, and CiteSpace software. A total of 47231 TBI-related publications were identified through database retrieval. The annual number of publications on TBI has increased steadily over the past twenty years and the number in the year 2022 is sevenfold higher than that in 2000. The United States of America (USA) was the leading country in both numbers of publications and citations, which is consistent with the finding that it had the most funding agencies. Menon DK was the author with the highest influence and the University of California System was the most productive affiliation. Moreover, keywords analysis suggested that the research topics can be mainly divided into six categories: management, rehabilitation, mechanisms, concussion, neuroimaging, and neuroendocrine. This study visualized the trends and focuses of scientific research related to TBI, both quantitatively and qualitatively. The USA had a relatively high academic impact owing to its productive experts and institutions in this field. Neuroinflammation, machine learning, tranexamic acid, and extracellular vesicles are currently hot topics in the field of TBI.
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Affiliation(s)
- Yan-Rui Long
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Department of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Zhao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fu-Chi Zhang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Li
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-Wen Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hong-Quan Niu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jin Lei
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Pittsburgh Institute of Brain Disorders & Recovery and Department of Neurology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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12
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Kamil M, Muttaqin Z, Hanaya R, Arita K, Yoshimoto K. Bibliometric Analysis of the Neurosurgery Publication Productivity of Southeast Asia in 2011-2020. World Neurosurg 2023; 172:e490-e498. [PMID: 36681320 DOI: 10.1016/j.wneu.2023.01.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is a large disparity between the quality of neurosurgical research in developed and developing nations, including the Association of Southeast Asian Nations (ASEAN). Bibliometric analysis is an appropriate method for evaluating the quality of research in a geographic region. We analyzed the neurosurgery reports published by the ASEAN countries to highlight regional productivity in neurosurgery research. METHODS We performed a bibliometric analysis of neurosurgery reports from the ASEAN countries between 2011 and 2020. We described the publication number, study type, and field of study of the publication articles. In addition, we assessed the correlations between the neurosurgery research productivity of these countries and the neurosurgeon ratio, medical doctor ratio, per capita gross domestic product, and health expenditure per capita. RESULTS We identified 1939 neurosurgeons in the ASEAN region; 570 articles were published by neurosurgeons in the region between 2011 and 2020. Singaporean neurosurgeons were the most productive, with 177 articles, accounting for 31% of the total ASEAN neurosurgeon publications in the study period. However, there has been a rapid recent increase in the number of articles. Case reports and tumors were the dominant type and field of the articles, respectively. There was no significant correlation between the neurosurgical research productivity of the ASEAN countries and the neurosurgeon ratio, medical doctor ratio, per capita gross domestic product, and health expenditure per capita. CONCLUSIONS By analyzing the neurosurgery publications from ASEAN countries over the previous decade, we highlight the status of neurosurgical research in these countries.
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Affiliation(s)
- Muhammad Kamil
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Neurosurgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
| | - Zainal Muttaqin
- Department of Neurosurgery, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Ryosuke Hanaya
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazunori Arita
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Neurosurgery, Izumi Regional Medical Center, Izumi, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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13
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Servadei F, Cannizzaro D, Zaed I, Iaccarino C, Cardia A. Neurotrauma Care: A Worldwide Perspective. J Neurotrauma 2023; 40:597-601. [PMID: 36893218 DOI: 10.1089/neu.2023.29137.fs] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Affiliation(s)
- Franco Servadei
- Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
| | - Delia Cannizzaro
- Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Corrado Iaccarino
- Neurosurgery Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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14
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Abu-Bonsrah N, Dada OE, Haizel-Cobbina J, Ukachukwu A, Spann M, Adu KO, Banson M, Bandoh D, Sarpong K, Dadey D, Ametefe M, Kanmounye US, Totimeh T, Groves ML. Understanding the Ghanaian Neurosurgical Literature: A Scoping Review and Bibliometric Analysis. World Neurosurg 2023; 169:12-19. [PMID: 36265747 DOI: 10.1016/j.wneu.2022.10.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research serves to bolster clinical neurosurgery by critically assessing various disease pathologies, while identifying important challenges and opportunities. However, there is limited information on the landscape of the Ghanaian neurosurgical literature. METHODS A scoping review and bibliometric analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, Global Index Medicus, and Web of Science electronic databases were searched from inception until December 21, 2021 for English language articles about neurosurgery in Ghana. RESULTS 927 articles were identified and 66 were ultimately included in the analysis. A majority of them, 42.4%, were retrospective cohort studies, with 62.1% published after 2010. There were no randomized controlled or basic science studies. Most articles were published in the West African Journal of Medicine (24.2%) and non-infectious/non-traumatic spinal pathology was the most commonly discussed topic (22.7%); 66.7% of articles included only authors affiliated with Ghanaian institutions, and international collaborators frequently originated from the United States (15.9%). Only 22.7% of the manuscripts reported a funding source. Commonly reported challenges included limited sample sizes, delays in diagnosis and treatment, and lack of proper diagnostic tools and specialized care. CONCLUSIONS This review revealed that while the Ghanaian academic neurosurgery output has been increasing over time, these have been limited to cohort studies largely assessing spine pathology. The Ghanaian neurosurgical research environment may be bolstered by an increase in research funding, the establishment of longitudinal clinical databases, training in research methodology, increased incentives for researchers, strengthening of research collaborative networks, and increased engagement of neurosurgical trainees in research.
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Affiliation(s)
- Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
| | | | - Joseline Haizel-Cobbina
- Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alvan Ukachukwu
- Duke Global Neurosurgery and Neurology, Duke Hospital Department of Neurosurgery, Durham, North Carolina, USA
| | - Marcus Spann
- Informationist Services, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kojo Okyere Adu
- Department of Internal Medicine, LEKMA Hospital, Accra, Ghana
| | - Mabel Banson
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Dickson Bandoh
- Department of Neurosurgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Kwadwo Sarpong
- Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - David Dadey
- Department of Neurosurgery, Stanford University School of Medicine, San Francisco, California, USA
| | - Mawuli Ametefe
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Teddy Totimeh
- Department of Neurosurgery, University of Ghana Medical Center, Accra, Ghana
| | - Mari L Groves
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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15
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Paradie E, Warman PI, Waguia-Kouam R, Seas A, Qiu L, Shlobin NA, Carpenter K, Hughes J, von Isenburg M, Haglund MM, Fuller AT, Ukachukwu AEK. The Scope, Growth, and Inequities of the Global Neurosurgery Literature: A Bibliometric Analysis. World Neurosurg 2022; 167:e670-e684. [PMID: 36028109 DOI: 10.1016/j.wneu.2022.08.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Here, we evaluate the evolution and growth of global neurosurgery publications over time, further focusing on the contributions and impact of authors in low- and middle-income countries (LMICs). METHODS In this systematic bibliometric analysis, we conducted a two-stage blinded screening process of global neurosurgery publications from 5 databases from inception through July 2021. Articles involving multi-national/multi-institutional research collaborations, detailing any area of global neurosurgery collaboration, or influencing global neurosurgery practice were included. Statistical hypothesis testing was conducted to analyze trends and hypotheses of LMIC authorship contributions. RESULTS The number of global neurosurgery publications has soared in the last decade. Overall, authors from HIC countries were most commonly from the US (41.1%), Canada (4.0%), and the UK (3.9%), while authors from LMIC countries were most commonly from Uganda (4.2%), Tanzania (2.6%), Cameroon (1.8%), and India (1.8%). Over a quarter (28%) of publications had no LMIC authors, while only 11% had 3 or more LMIC authors. The proportion of LMIC authors (LMIC-R) was not correlated with the citation rate of individual articles or with the year of publication, and a positive trend emerged when the LMIC-R of top-publishing LMICs was individually examined and compared to the year of publication. CONCLUSIONS Despite recent growth, the number of global neurosurgery publications arising from LMICs pales in comparison to those from HICs. Collaborative efforts between certain HICs and LMICs have likely contributed to the observed increase in LMIC author independence over time.
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Affiliation(s)
- Emma Paradie
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Pranav I Warman
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Romaric Waguia-Kouam
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Andreas Seas
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Liming Qiu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Singapore General Hospital, Singhealth, Singapore, Singapore
| | - Nathan A Shlobin
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kennedy Carpenter
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA
| | - Jasmine Hughes
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Megan von Isenburg
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA.
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16
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Ukachukwu AEK, Seas A, Petitt Z, Dai KZ, Shlobin NA, Khalafallah AM, Patel DN, Rippeon E, von Isenburg M, Haglund MM, Fuller AT. Assessing the Success and Sustainability of Global Neurosurgery Collaborations: Systematic Review and Adaptation of the Framework for Assessment of InteRNational Surgical Success Criteria. World Neurosurg 2022; 167:111-121. [PMID: 36058483 DOI: 10.1016/j.wneu.2022.08.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND The high unmet neurosurgical burden in low- and middle-income countries has necessitated multiple global neurosurgical collaborations. We identified these collaborations and their peer-reviewed journal publications and evaluated them using a modified version of the Framework for Assessment of InteRNational Surgical Success (FAIRNeSS). METHODS A systematic literature review yielded 265 articles describing neurosurgery-focused collaborations. A subset of 101 papers from 17 collaborations were evaluated with the modified FAIRNeSS criteria. Analysis of trends was performed for both individual articles and collaborations. RESULTS Most of the articles were general reviews (64), and most focused on clinical research (115). The leading collaboration focus was workforce and infrastructure development (45%). Composite FAIRNeSS scores ranged from 7/34 to 30/34. Average FAIRNeSS scores for individual articles ranged from 0.25 to 26.75, while collaboration-wide FAIRNeSS score averages ranged from 5.25 to 20.04. There was significant variability within each subset of FAIRNeSS indicators (P value <0.001). Short-term goals had higher scores than medium- and long-term goals (P value <0.001). Collaboration composite scores correlated with the number of papers published (R2 = 0.400, P = 0.007) but not with the number of years active (R2 = 0.072, P = 0.3). Finally, the overall agreement between reviewers was 53.5%, and the overall correlation was 38.5%. CONCLUSIONS Global neurosurgery has no established metrics for evaluating collaborations; therefore, we adapted the FAIRNeSS criteria to do so. The criteria may not be well suited for measuring the success and sustainability of global neurosurgery collaborations, creating a need to develop a more applicable alternate set of metrics.
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Affiliation(s)
- Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA
| | - Andreas Seas
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Zoey Petitt
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Kathy Z Dai
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Nathan A Shlobin
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Adham M Khalafallah
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, University of Miami, Miami, Florida, USA
| | - Dev N Patel
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Aureus University School of Medicine, Oranjestad, Aruba; NYU Langone Health, New York, New York, USA
| | - Elena Rippeon
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Megan von Isenburg
- Duke University Medical Center Library & Archives, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA.
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17
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Shlobin NA, Punchak MA, Boyke AE, Beestrum M, Gutzman K, Rosseau G. Language and Geographic Representation of Neurosurgical Journals: A Meta-Science Study. World Neurosurg 2022; 166:171-183. [PMID: 35953039 DOI: 10.1016/j.wneu.2022.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Medical journals have a role in promoting representation of neurosurgeons who speak primary languages other than English. We sought to characterize the language of publication and geographic origin of neurosurgical journals, delineate associations between impact factor (IF) and language and geographic variables, and describe steps to overcome language barriers to publishing. METHODS Web of Science, Scopus, and Ulrich's Serial Analysis system were searched for neurosurgery journals. The journals were screened for relevance. Language of publication, country and World Health Organization region, World Bank income status and gross domestic product, and citation metrics were extracted. RESULTS Of 867 journals, 74 neurosurgical journals were included. Common publication languages were English (52, 70.3%), Mandarin (5, 6.8%), and Spanish (4, 5.4%). Countries of publication for the greatest number of journals were the United States (23, 31.1%), United Kingdom (8, 10.8%), and China (6, 8.1%). Most journals originated from the Americas region (29, 39.2%), the European region (28, 37.8%), and from high-income countries (n = 54, 73.0%). Median IF was 1.55 (interquartile range [IQR] 0.89-2.40). Journals written in English (1.77 [IQR 1.00-2.87], P = 0.032) and from high-income countries (1.81 [IQR 1.0-2.70], P = 0.046) had highest median IF. When excluding outliers, there was a small but positive correlation between per capita gross domestic product and IF (β = 0.021, P = 0.03, R2 = 0.097). CONCLUSIONS Language concordance represents a substantial barrier to research equity in neurosurgery, limiting dissemination of ideas of merit that currently have inadequate outlets for readership. Initiatives aimed at increasing the accessibility of neurosurgical publishing to underrepresented authors are essential.
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Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Maria A Punchak
- Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Andre E Boyke
- Department of Neurosurgery, Mount Sinai Icahn School of Medicine, New York, New York, USA
| | - Molly Beestrum
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karen Gutzman
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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18
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Cannizzaro D, Safa A, Bisoglio A, Jelmoni AJ, Zaed I, Tropeano MP, Al Fauzi A, Bajamal AH, Khan T, Kolias A, Hutchinson P, Servadei F. Second Footprint of Reports from Low- and Low- to Middle-Income Countries in the Neurosurgical Data: A Study from 2018–2020 Compared with Data from 2015–2017. World Neurosurg 2022; 168:e666-e674. [DOI: 10.1016/j.wneu.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
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19
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Sarpong K, Fadalla T, Garba DL, Suliman M, Rolle M, Ammar A, Hussen H, Park KB. Access to training in neurosurgery (Part 1): Global perspectives and contributing factors of barriers to access. BRAIN & SPINE 2022; 2:100900. [PMID: 36248138 PMCID: PMC9560711 DOI: 10.1016/j.bas.2022.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/21/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022]
Abstract
Introduction Neurological disorders are one of the leading causes of death and disability adjusted life years (DALYs). Efforts have been made to increase the neurosurgical workforce in an attempt to address the global disease burden. Despite these efforts, there continues to be a shortage of neurosurgeons in both high-income countries (HICs) and low-and middle-income countries (LMICs). Research question The aim of the study was to identify the barriers to neurosurgical training in LMICs and HICs. Materials and methods We administered an electronic survey targeting medical students, neurosurgery residents, and recent neurosurgery graduates from 69 countries in both HICs and LMICs. Questions were framed to assess barriers to training. Results Of the 198 responses received (31.3% response rate), 72% identified as male, 27% female, and 0.5% as non-binary gender. 33 respondents were from HICs and 165 were from LMICs. 70.1% of respondents reported no availability of dissection labs in their home institutions. There was a significant difference in availability of subspecialty training between LMICs and HMICs (p = 0.001) but no significance was seen for competitiveness of programs (p = 0.473). Discussion and conclusion There are limitations to our study: it is not comprehensive of training programs globally, there is sampling bias, especially among LMICs, and the accuracy of responses is unclear. Nonetheless, our results highlight the need for a deliberate focus on designing and implementing both short and long term goals in tackling barriers to access to neurosurgical training, with a conscientious effort to involve interested stakeholders and governments to invest in the training and education of their neurosurgical workforce.
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Affiliation(s)
- Kwadwo Sarpong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Tarig Fadalla
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Deen L. Garba
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Mazin Suliman
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Myron Rolle
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Adam Ammar
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Haytham Hussen
- Ribat NeuroSpine Center, Ribat University Hospital, The National Ribat University, Khartoum, Sudan
| | - Kee B. Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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20
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Servadei F, Zaed I. Editorial. The role of telemedicine in countries with limited facilities: which peculiarities? Neurosurg Focus 2022; 52:E6. [DOI: 10.3171/2022.3.focus22137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Franco Servadei
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan
- Department of Neurosurgery, IRCCS—Humanitas Research Hospital, Rozzano, Milan; and
| | - Ismail Zaed
- Division of Neurosurgery, ASST Ovest, Legnano Hospital, Legnano, Milan, Italy
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21
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Servadei F, Cannizzaro D, Thango N, Kolias A, Hutchinson P, Esene I, Rubiano A. In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals. Neurosurgery 2022; 90:e195-e196. [PMID: 35394452 DOI: 10.1227/neu.0000000000002002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Franco Servadei
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Delia Cannizzaro
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - Nqobile Thango
- Department of Surgery, Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Angelos Kolias
- Department of Clinical Neurosciences, Division of Neurosurgery, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK.,NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Peter Hutchinson
- Department of Clinical Neurosciences, Division of Neurosurgery, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK.,NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Ignatius Esene
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.,Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
| | - Andres Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.,INUB-Meditech Research Group, Neuroscience Institute, Universidad El Bosque, Bogota, Colombia.,Meditech Foundation, Valle-Salud IPS Clinical Network, Cali, Colombia
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22
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Detchou D, Ibrahim LI, Tissot MIJ, Boyke AE, Shlobin NA, Sharma V, Rolle ML. In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals. Neurosurgery 2022; 90:e197-e198. [PMID: 35394475 DOI: 10.1227/neu.0000000000002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Donald Detchou
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Frazier Scholar Program, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Guggenheim Scholar Program, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Thomas William Langfitt Neurosurgical Society, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lina I Ibrahim
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Thomas William Langfitt Neurosurgical Society, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.,Stanford University, Stanford, California, USA
| | - Marianne I J Tissot
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Thomas William Langfitt Neurosurgical Society, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andre E Boyke
- Department of Neurosurgery, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Vaishnavi Sharma
- Department of Neurosurgery, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Myron L Rolle
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
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23
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Rahman S, Rahman MM, Khan RA, Chowdhury M. In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals. Neurosurgery 2022; 90:e58. [PMID: 34995219 DOI: 10.1227/neu.0000000000001808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/17/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sabrina Rahman
- Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh
| | - Md Moshiur Rahman
- Neurosurgery Department, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
| | - Robert Ahmed Khan
- Neurosurgery Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Safa A. Letter to the Editor Regarding "Perception of Neurosurgery Residents and Attendings on Online Webinars During COVID-19 Pandemic and Implications on Future Education". World Neurosurg 2021; 154:190. [PMID: 34583484 DOI: 10.1016/j.wneu.2021.04.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Adrian Safa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
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25
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Whiffin CJ, Smith BG, Esene IN, Karekezi C, Bashford T, Mukhtar Khan M, Hutchinson PJ, Kolias AG, Fontoura Solla DJ, Paiva WS, Figaji A. Neurosurgeons' experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis. BMJ Open 2021; 11:e051806. [PMID: 34551952 PMCID: PMC8461280 DOI: 10.1136/bmjopen-2021-051806] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Low-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons' experiences of, aspirations for, and ability to conduct and disseminate clinical research in LMICs. DESIGN This was a two-stage inductive qualitative study situated within the naturalistic paradigm. This study committed to an interpretivist way of knowing (epistemology), and considered reality subjective and multiple (ontology). Data collection used online methods and included a web-based survey tool for demographic data, an asynchronous online focus group and follow-up semistructured interviews. Data were analysed using Braun and Clarke's Reflexive Thematic Analysis supported by NVivo V.12. SETTING LMICs. PARTICIPANTS In April-July 2020, 26 neurosurgeons from 11 LMICs participated in this study (n=24 in the focus groups, n=20 in follow-up interviews). RESULTS The analysis gave rise to five themes: The local landscape; creating capacity; reach and impact; collaborative inquiry; growth and sustainability. Each theme contained an inhibitor and stimulus to neurosurgeons conducting and disseminating clinical research, interpreted as 'the neurosurgical research potential in LMICs'. Mentorship, education, infrastructure, impact and engagement were identified as specific accelerators. Whereas lack of generalisability, absence of dissemination and dissemination without peer review may desensitise the impact of research conducted by neurosurgeons. CONCLUSION The geographical, political and population complexities make research endeavour challenging for neurosurgeons in LMICs. Yet in spite of, and because of, these complexities LMICs provide rich opportunities to advance global neurosurgery. More studies are required to evaluate the specific effects of accelerators of research conducted by neurosurgeons and to understand the effects of desensitisers on high-quality, high-impact clinical research.
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Affiliation(s)
- Charlotte Jane Whiffin
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- College of Health Psychology and Social Care, University of Derby, Derby, UK
| | - Brandon George Smith
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Ignatius N Esene
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, NW Region, Cameroon
| | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Kigali City, Rwanda
- Young Neurosurgeons Committee, World Federation of Neurosurgical Societies, Nyon, Switzerland
| | - Tom Bashford
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Muhammad Mukhtar Khan
- Young Neurosurgeons Committee, World Federation of Neurosurgical Societies, Nyon, Switzerland
- Neurosurgery, Northwest School of Medicine, Northwest General Hospital & Research Center, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Peter John Hutchinson
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Angelos G Kolias
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | | | - Wellingson S Paiva
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Department of Neurology, Division of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Anthony Figaji
- University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK
- Division of Neurosurgery, Red Cross Children's Hospital & University of Cape Town, Cape Town, South Africa
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26
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Shlobin NA, Moher D. Commentary: Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement: What Neurosurgeons Should Know. Neurosurgery 2021; 89:E267-E268. [PMID: 34352888 DOI: 10.1093/neuros/nyab289] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, Illinois, USA
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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27
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Aristizabal P, Burns LP, Kumar NV, Perdomo BP, Rivera-Gomez R, Ornelas MA, Gonda D, Malicki D, Thornburg CD, Roberts W, Levy ML, Crawford JR. Improving Pediatric Neuro-Oncology Survival Disparities in the United States-Mexico Border Region: A Cross-Border Initiative Between San Diego, California, and Tijuana, Mexico. JCO Glob Oncol 2021; 6:1791-1802. [PMID: 33216645 PMCID: PMC7713516 DOI: 10.1200/go.20.00377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Treatment of children with CNS tumors (CNSTs) demands a complex, interdisciplinary approach that is rarely available in low- and middle-income countries. We established the Cross-Border Neuro-Oncology Program (CBNP) between Rady Children's Hospital, San Diego (RCHSD), and Hospital General, Tijuana (HGT), Mexico, to provide access to neuro-oncology care, including neurosurgic services, for children with CNSTs diagnosed at HGT. Our purpose was to assess the feasibility of the CBNP across the United States-Mexico border and improve survival for children with CNSTs at HGT by implementing the CBNP. PATIENTS AND METHODS We prospectively assessed clinicopathologic profiles, the extent of resection, progression-free survival, and overall survival (OS) in children with CNSTs at HGT from 2010 to 2017. RESULTS Sixty patients with CNSTs participated in the CBNP during the study period. The most common diagnoses were low-grade glioma (24.5%) and medulloblastoma (22.4%). Of patients who were eligible for surgery, 49 underwent resection at RCHSD and returned to HGT for collaborative management. Gross total resection was achieved in 78% of cases at RCHSD compared with 0% at HGT (P < .001) and was a predictor of 5-year OS (hazard ratio, 0.250; 95% CI, 0.067 to 0.934; P = .024). Five-year OS improved from 0% before 2010 to 52% in 2017. CONCLUSION The CBNP facilitated access to complex neuro-oncology care for underserved children in Mexico through binational exchanges of resources and expertise. Survival for patients in the CBNP dramatically improved. Gross total resection at RCHSD was associated with higher OS, highlighting the critical role of experienced neurosurgeons in the treatment of CNSTs. The CBNP model offers an attractive alternative for children with CNSTs in low- and middle-income countries who require complex neuro-oncology care, particularly those in close proximity to institutions in high-income countries with extensive neuro-oncology expertise.
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Affiliation(s)
- Paula Aristizabal
- Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, CA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, La Jolla, CA.,Population Sciences, Disparities and Community Engagement, Moores Cancer Center, University of California, San Diego, La Jolla, CA
| | - Luke P Burns
- School of Medicine, University of California, San Diego, La Jolla, CA
| | - Nikhil V Kumar
- School of Medicine, University of California, San Diego, La Jolla, CA
| | - Bianca P Perdomo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Rebeca Rivera-Gomez
- Hospital General de Tijuana/Universidad Autónoma de Baja California Tijuana, Baja California, Mexico
| | - Mario A Ornelas
- Hospital General de Tijuana/Universidad Autónoma de Baja California Tijuana, Baja California, Mexico
| | - David Gonda
- Department of Neurosciences, University of California, San Diego, La Jolla, CA.,Division of Pediatric Neurosurgery, Department of Neurosurgery, University of California, San Diego, La Jolla, CA
| | - Denise Malicki
- Department of Pathology, University of California, San Diego, La Jolla, CA
| | - Courtney D Thornburg
- Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, CA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - William Roberts
- Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, CA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Michael L Levy
- Department of Neurosciences, University of California, San Diego, La Jolla, CA.,Division of Pediatric Neurosurgery, Department of Neurosurgery, University of California, San Diego, La Jolla, CA
| | - John R Crawford
- Peckham Center for Cancer and Blood Disorders, Rady Children's Hospital San Diego, San Diego, CA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California, San Diego, La Jolla, CA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA.,Division of Pediatric Neurology, Department of Pediatrics, University of California San Diego, La Jolla, CA
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28
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Letter to the Editor: The Role of Modern Simulation Techniques in Neurovascular Surgery Training. World Neurosurg 2021; 148:233. [PMID: 33770840 DOI: 10.1016/j.wneu.2021.01.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/20/2022]
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29
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Zaed I, Tinterri B, Licci M, Cannizzaro D. Letter to the Editor Regarding "Medical Student Concerns Relating to Neurosurgery Education During COVID-19". World Neurosurg 2021; 150:218-219. [PMID: 34098637 DOI: 10.1016/j.wneu.2020.12.152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Ismail Zaed
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milano, Italy
| | - Benedetta Tinterri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
| | - Maria Licci
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Delia Cannizzaro
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milano, Italy
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30
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Servadei F, Cannizzaro D. Effects on traumatic brain injured patients of COVID pandemia: which responses from neurosurgical departments? Acta Neurochir (Wien) 2021; 163:1051-1052. [PMID: 33486636 DOI: 10.1007/s00701-021-04724-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
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31
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Smith BG, Whiffin CJ, Esene IN, Karekezi C, Bashford T, Mukhtar Khan M, Fontoura Solla DJ, Indira Devi B, Hutchinson PJ, Kolias AG, Figaji A, Rubiano AM. Neurotrauma clinicians' perspectives on the contextual challenges associated with long-term follow-up following traumatic brain injury in low-income and middle-income countries: a qualitative study protocol. BMJ Open 2021; 11:e041442. [PMID: 33664068 PMCID: PMC7934765 DOI: 10.1136/bmjopen-2020-041442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is a global public health concern; however, low/middle-income countries (LMICs) face the greatest burden. The WHO recognises the significant differences between patient outcomes following injuries in high-income countries versus those in LMICs. Outcome data are not reliably recorded in LMICs and despite improved injury surveillance data, data on disability and long-term functional outcomes remain poorly recorded. Therefore, the full picture of outcome post-TBI in LMICs is largely unknown. METHODS AND ANALYSIS This is a cross-sectional pragmatic qualitative study using individual semistructured interviews with clinicians who have experience of neurotrauma in LMICs. The aim of this study is to understand the contextual challenges associated with long-term follow-up of patients following TBI in LMICs. For the purpose of the study, we define 'long-term' as any data collected following discharge from hospital. We aim to conduct individual semistructured interviews with 24-48 neurosurgeons, beginning February 2020. Interviews will be recorded and transcribed verbatim. A reflexive thematic analysis will be conducted supported by NVivo software. ETHICS AND DISSEMINATION The University of Cambridge Psychology Research Ethics Committee approved this study in February 2020. Ethical issues within this study include consent, confidentiality and anonymity, and data protection. Participants will provide informed consent and their contributions will be kept confidential. Participants will be free to withdraw at any time without penalty; however, their interview data can only be withdrawn up to 1 week after data collection. Findings generated from the study will be shared with relevant stakeholders such as the World Federation of Neurosurgical Societies and disseminated in conference presentations and journal publications.
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Affiliation(s)
- Brandon George Smith
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Charlotte Jane Whiffin
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- College of Health of Social Care, University of Derby, Derby, UK
| | - Ignatius N Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Northwest Region, Cameroon
| | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Tom Bashford
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Muhammad Mukhtar Khan
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosurgery, Northwest General Hospital and Research Center, Peshawar, Pakistan
| | - Davi Jorge Fontoura Solla
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosciences and Behaviour Sciences, University of São Paulo, Ribeirao Preto, Brazil
| | - Bhagavatula Indira Devi
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Peter John Hutchinson
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Angelos G Kolias
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Anthony Figaji
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, University of Cape Town, Rondebosch, South Africa
| | - Andres M Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Neurosciences Institute, Department of Neurosurgery, El Bosque University, Bogota, Colombia
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32
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Behmer Hansen RT, Behmer Hansen RA, Behmer VA, Gold J, Silva N, Dubey A, Nanda A. Update on the global neurosurgery movement: A systematic review of international vernacular, research trends, and authorship. J Clin Neurosci 2020; 79:183-190. [PMID: 33070893 DOI: 10.1016/j.jocn.2020.07.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 12/20/2022]
Abstract
In 2015, key global and neurosurgical organizations increased collaboration to improve neurosurgical care access, delivery, and outcomes, particularly in low- to middle-income countries (LMICs); sparking what has been termed the global neurosurgery movement. The authors sought to assess trends in usage of the term 'global neurosurgery' in academic literature with particular focus on author affiliations, world regions most frequently discussed, and topics of research performed. A PubMed search for articles indexed as 'global neurosurgery' was completed yielding 277 articles which met inclusion criteria. It was found that over time, use of the term 'global neurosurgery' has increased, with increasing growth notable starting in the year 2008 and continuing into October 2019. Statistical comparisons showed authors with affiliated global neurosurgery centers were more likely to publish studies related to the continent of Africa (47.4% vs 15.9%, p < 0.001), and less likely to focus on countries in Asia (2.6% vs 20.9%, p = 0.023). Use of the term 'global neurosurgery' in the article abstract/title/keywords was associated with focus on LMICs (18.6% vs. 5.1%, p = 0.006). Use of the term 'global neurosurgery' was associated with workforce and capacity as research topics (41.9% vs 22.6%, p = 0.036). While fairly new, the global neurosurgery movement has seen a rapid increase in publications utilizing the term 'global neurosurgery.' Articles frequently have focused on collaborative, targeted workforce capacity building in LMICs. We encourage the development of more global neurosurgery academic centers, especially in non-USA countries, to continue this momentum.
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Affiliation(s)
| | - Ryan A Behmer Hansen
- Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, NJ, United States.
| | | | - Justin Gold
- University of Rhode Island, Kingston, RI, United States.
| | - Nicole Silva
- Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, NJ, United States.
| | - Arjun Dubey
- Wollongong Hospital - NSW Health, Wollongong, Australia.
| | - Anil Nanda
- Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, NJ, United States.
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33
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Whiffin CJ, Smith BG, Esene IN, Karekezi C, Bashford T, Khan MM, Fontoura Solla DJ, Hutchinson PJ, Kolias A. Neurosurgeons' experiences of conducting and disseminating clinical research in low- and middle-income countries: a qualitative study protocol. BMJ Open 2020; 10:e038939. [PMID: 32792451 PMCID: PMC7430326 DOI: 10.1136/bmjopen-2020-038939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Low-income and middle-income countries (LMICs) face the greatest burden of neurotrauma. However, most of the research published in scientific journals originates from high-income countries, suggesting those in LMICs are either not engaging in research or are not publishing it. Evidence originating in high-income countries may not be generalisable to LMICs; therefore, it is important to nurture research capacity in LMICs so that a relevant evidence base can be developed. However, little is published about specific challenges or contextual issues relevant to increasing research activity of neurosurgeons in LMICs. Therefore, the aim of this study was to understand neurosurgeons' experiences of, aspirations for and ability to conduct and disseminate clinical research in LMICs. METHODS AND ANALYSIS This is a pragmatic qualitative study situated within the naturalistic paradigm using focus groups and interviews with a purposive sample of neurosurgeons from LMICs. First, we will conduct asynchronous online focus groups with 36 neurosurgeons to broadly explore issues relevant to the study aim. Second, we will select 20 participants for follow-up semistructured interviews to explore concepts in more depth and detail than could be achieved in the focus group. Interviews will be audio-recorded and transcribed verbatim. A thematic analysis will be conducted following Braun and Clarke's six stages and will be supported by NVIVO software. ETHICS AND DISSEMINATION The University of Cambridge Psychology Research Ethics Committee reviewed this study and provided a favourable opinion in January 2020 (REF PRE.2020.006). Participants will provide informed consent, be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications.
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Affiliation(s)
- Charlotte J Whiffin
- College of Health and Social Care, University of Derby, Derby, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Brandon G Smith
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Ignatius N Esene
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, NW Region, Cameroon
| | - Claire Karekezi
- Department of Neurosurgery, Rwanda Military Hospital, Kigali, Kigali City, Rwanda
| | - Tom Bashford
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Muhammad Mukhtar Khan
- Neurosurgery, Northwest School of Medicine and Northwest General Hospital and Research Centre, Peshawar, Pakistan
| | - Davi J Fontoura Solla
- Department of Neurology, Division of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Peter J Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Angelos Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
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34
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Costa F, Servadei F. Guidelines in the modern era. J Neurosurg Sci 2020; 65:88-89. [PMID: 32618154 DOI: 10.23736/s0390-5616.20.05039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy -
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Science, Humanitas University, Milan, Italy
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35
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Tropeano MP, Spaggiari R, Ileyassoff H, Mabunda DJD, Anania CD, Costa F, Fornari M, Sharif S, Zileli M, Park KB, Servadei F. Traumatic Spine Injury: Which Discrepancy Between the Research Output and the Actual Burden of the Disease? World Neurosurg 2020; 142:e117-e125. [PMID: 32592959 DOI: 10.1016/j.wneu.2020.06.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Traumatic spinal injury (TSI) is a global health issue contributing to morbidity and mortality, especially in low- and middle-income countries. The aim of this study is to compare the epidemiological estimates of TSI with the corresponding amount of published papers for different regions. METHODS A bibliometric analysis was performed by collecting the number of publications concerning TSI from the PubMed database. Results were sorted according to the different geographical World Health Organization regions. A "publication-to-volume ratio" was obtained by comparing the average number of documents per year with the number of TSI cases across each region. RESULTS A total of 2304 articles were detected from 2008 to 2018. The major publishing regions were North America (AMR-US/Can: 843 articles, 36.6%) and Europe (EUR: 833, 36.2%), then Western Pacific (WPR: 410, 17.8%), Eastern Mediterranean (EMR: 73, 3.2%), South-East Asia (SEAR: 71, 3.1%), Latin America (AMR-L: 55, 2.4%), Africa (AFR: 19, 0.8%). The United States is the most publishing country in AMR-US/Can (86.0%), and Germany in EUR (22.4%). In 2018, EUR published 36.6% of papers versus AMR-US/Can 26.5% and WPR 25.7%, thanks to an increase in Chinese publications. The highest publication ratios of 4.63 and 2.68 were found for AMR-US/Can and EUR, respectively. The other were EMR (0.22), WPR (0.18), AMR-L (0.07), SEAR (0.03), and AFR (0.01). CONCLUSIONS A marked divide is currently found between countries with a high burden of TSI and those where there is most research interest, estimated as amount of publications. Data demonstrate the need for increased inclusiveness in guidelines generation from high-income countries including collection and analysis from low- and middle-income countries.
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Affiliation(s)
| | | | - Hernán Ileyassoff
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Carla D Anania
- Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Francesco Costa
- Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | | | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan
| | - Mehmet Zileli
- Department of Neurosurgery, Ege University, Izmir, Turkey
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Franco Servadei
- Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
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36
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Weiss HK, Garcia RM, Omiye JA, Vervoort D, Riestenberg R, Yerneni K, Murthy N, Wescott AB, Hutchinson P, Rosseau G. A Systematic Review of Neurosurgical Care in Low-Income Countries. World Neurosurg X 2020; 5:100068. [PMID: 31956859 PMCID: PMC6957821 DOI: 10.1016/j.wnsx.2019.100068] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/29/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE More than 5 billion individuals lack access to essential surgical care. Neurosurgical care is especially limited in low-income countries (LICs). Studies describing neurosurgical care in LICs are critical for understanding global disparities in access to neurosurgical procedures. To better understand these disparities, we conducted a systematic review of the literature identifying neurosurgical patients in LICs. METHODS MEDLINE (PubMed), Embase (embase.com), and Cochrane Library (Wiley) databases were systematically searched to retrieve studies describing neurosurgical care in LICs as defined by the World Bank Country and Lending Groups income classification. All databases were searched from their inception; no date or language limits were applied. All the articles were blindly reviewed by 2 individuals. Data from eligible studies were extracted and summarized. RESULTS Of the 4377 citations screened, 154 studies met inclusion criteria. The number of publications substantially increased over the study period, with 49% (n = 76) of studies published in the last 5 years. Twenty-six percent (n = 40) of studies had a first author, and 30% (n = 46) had a senior author, affiliated with a country different from the LIC of study. The most common neurosurgical diagnosis was traumatic brain injury (24%, n = 37), followed by hydrocephalus (26%, n = 40), and neoplastic intracranial mass (10%, n = 16). Of LICs, 43% (n = 15/35) had no published neurosurgical literature. CONCLUSIONS There is a significant deficit in the literature on neurosurgical care in LICs. Efforts must focus on supporting research initiatives in LICs to improve publication bias and understand disparities in access to neurosurgical care in the lowest-resource countries.
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Affiliation(s)
- Hannah K. Weiss
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Roxanna M. Garcia
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
- Institute for Public Health and Medicine (IPHAM), Center for Healthcare Studies, Northwestern University, Chicago, Illinois, USA
| | | | - Dominique Vervoort
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert Riestenberg
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Ketan Yerneni
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Nikhil Murthy
- Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA
| | - Annie B. Wescott
- Galter Health Sciences Library & Learning Center, Northwestern University, Chicago, Illinois, USA
| | - Peter Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital and University of Cambridge, Cambridge, United Kingdom
| | - Gail Rosseau
- Midwest Neurosurgical Associates, Oak Brook, Illinois, USA
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