Launching Effectiveness Research to Guide Practice in Neurosurgery: A National Institute Neurological Disorders and Stroke Workshop Report. Issue 4 (16th March 2017)

• Record Type: Journal Article
• Authors: Walicke, Patricia; Abosch, Aviva; Asher, Anthony; Barker, Fred G.; Ghogawala, Zoher; Harbaugh, Robert; Jehi, Lara; Kestle, John; Koroshetz, Walter; Little, Roderick; Rubin, Donald; Valadka, Alex; Wisniewski, Stephen; Chiocca, E. Antonio
• Is Part Of: Neurosurgery. Volume 80:Issue 4(2017)
• Page Start: 505
• Page End: 514
• Publication Date: 2017-03-16
• Subjects: Clinical trials -- Effectiveness research -- Randomized controlled trial -- Registry -- Equipoise; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyw133
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: This workshop addressed challenges of clinical research in neurosurgery. Randomized controlled clinical trials (RCTs) have high internal validity, but often insufficiently generalize to real-world practice. Observational studies are inclusive but often lack sufficient rigor. The workshop considered possible solutions, such as (1) statistical methods for demonstrating causality using observational data; (2) characteristics required of a registry supporting effectiveness research; (3) trial designs combining advantages of observational studies and RCTs; and (4) equipoise, an identified challenge for RCTs. In the future, advances in information technology potentially could lead to creation of a massive database where clinical data from all neurosurgeons are integrated and analyzed, ending the separation of clinical research and practice and leading to a new "science of practice."