Neurosurgical Randomized Trials in Low- and Middle-Income Countries

LATEST ARTICLES
SEARCH INDEX
SUGGEST ARTICLE
THE OSI COLLECTIONS
ABOUT THE OSI

OSI STATISTICS

Total abstracts indexed:
534
Audio abstracts:
101
Open access articles:
474
Pending review:
115
Annotations added:
2
Countries represented:
91
No. of contributors:
10
Bookmarks made:
12
Specialities covered:
19

Neurosurgical Randomized Trials in Low- and Middle-Income Countries


JournalNeurosurgery
Publication date – Mar – 2020
Authors – Griswold DP, Khan AA, Chao TE, Clark DJ, Budohoski K, Devi BI, Azad TD, Grant GA, Trivedi RA, Rubiano AM, Johnson WD, Park KB, Broekman M, Servadei F, Hutchinson PJ, Kolias AG
Keywordsaccess to care, Global Health, Global neurosurgery, global surgery, Health disparities, Low-and middle-income countries, Neurosurgery, Neurotrauma, Research, Research capacity strengthening, Spinal surgery
Open access – Yes
SpecialityNeurosurgery
World region Global

Language – English
Submitted to the One Surgery Index on May 29, 2020 at 9:42 am
Abstract:

BACKGROUND:The setting of a randomized trial can determine whether its findings are generalizable and can therefore apply to different settings. The contribution of low- and middle-income countries (LMICs) to neurosurgical randomized trials has not been systematically described before. OBJECTIVE:To perform a systematic analysis of design characteristics and methodology, funding source, and interventions studied between trials led by and/or conducted in high-income countries (HICs) vs LMICs. METHODS:From January 2003 to July 2016, English-language trials with >5 patients assessing any one neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library. Income classification for each country was assessed using the World Bank Atlas method. RESULTS:A total of 73.3% of the 397 studies that met inclusion criteria were led by HICs, whereas 26.7% were led by LMICs. Of the 106 LMIC-led studies, 71 were led by China. If China is excluded, only 8.8% were led by LMICs. HIC-led trials enrolled a median of 92 patients vs a median of 65 patients in LMIC-led trials. HIC-led trials enrolled from 7.6 sites vs 1.8 sites in LMIC-led studies. Over half of LMIC-led trials were institutionally funded (54.7%). The majority of both HIC- and LMIC-led trials evaluated spinal neurosurgery, 68% and 71.7%, respectively. CONCLUSION:We have established that there is a substantial disparity between HICs and LMICs in the number of published neurosurgical trials. A concerted effort to invest in research capacity building in LMICs is an essential step towards ensuring context- and resource-specific high-quality evidence is generated.

OSI Number – 20432
PMID – 32171011

Public annotations on this article:
No public annotations yet