Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey
Ali A Asadi-Pooya 1, Francesco Brigo 2, Eugen Trinka 3, Simona Lattanzi 4, Ioannis Karakis 5, Nirmeen Adel Kishk 6, Kette D Valente 7, Asel Jusupova 8, Saule T Turuspekova 9, Anilu Daza-Restrepo 10, Guilca Contreras 11, Mansur A Kutlubaev 12, Alla Guekht 13, Abbas Rahimi-Jaberi 14, Ghaieb Aljandeel 15, Yamile Calle-Lopez 16, Taoufik Alsaadi 17, Abdulaziz Ashkanani 18, Lakshmi Narasimhan Ranganathan 19, Abdullah Al-Asmi 20, Samson G Khachatryan 21, David Gigineishvili 22, Boulenouar Mesraoua 23, Naluca Mwendaweli 24
Affiliations
Affiliations
- 1Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
- 2Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy.
- 3Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg 5020, Austria; Institute Neuroscience Christian-Doppler Medical Centre, Paracelsus Medical University, Austria; Centre for Cognitive Neuroscience, Salzburg 5020, Austria; Department of Public Health, Health Services Research and Health Technology Assessment, Member of the European Referencenetwork EpiCARE., Medical Informatics and Technology, UMIT - University for Health Sciences, Hall in Tirol, Austria.
- 4Department of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
- 5Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- 6Department of Neurology, Cairo University Epilepsy Unit (CUEU), School of Medicine, Cairo University, Cairo, Egypt.
- 7Deparment of Psychiatry, Laboratory of Clinical Neurophysiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.
- 8Neurology and Clinical Genetics Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
- 9Department of Nervous Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
- 10ENyS CONICET - Neuroscience and Epilepsy service, El Cruce Hospital "Dr. Néstor Kirchner", Buenos Aires, Argentina.
- 11Epilepsy Unit. La Trinidad Medical Center, Caracas, Venezuela.
- 12Department of Neurology, Bashkir State Medical University, Ufa. Russia.
- 13Department of Neurology, Nerosurgery and Medical Genetics, Moscow Research and Clinical Center for Neurospychiatry, Pirogov Russian National Research Medical University, Moscow, Russia.
- 14Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- 15Iraqi Council for Medical Specializations, Faculty of Epileptology, Medical City, Baghdad, Iraq.
- 16Neurology Section, University of Antioquia, Fundación Clínica del Norte-Neuroclínica, Medellín Colombia.
- 17Deptartment of Neurology, American Center for Psychiatry and Neurology, and Khalifa University, Abu Dhabi, UAE.
- 18Ahmadi Hospital, Kuwait, Kuwait.
- 19Madras Medical College, Institute of Neurology, Chennai, Tamil Nadu, India.
- 20Neurology unit, Department of Medicine, College of Medicine and Health Sceinces and Sultan Qaboos University Hospital, Sultan Qaboos University, Oman.
- 21Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia.
- 22Department of Neurology & Neurosurgery, Institute of Neurology, Javakhishvili Tbilisi State University, Tbilisi, Georgia.
- 23Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar.
- 24Ministry of Health, University Teaching Hospital, Lusaka Province, Zambia.
Abstract
Purpose: To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide.
Methods: Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy.
Results: In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p < 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients.
Conclusion: This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug-resistant seizures worldwide.
Keywords: Brain; Epilepsy; Seizure; Surgery; Treatment.
Conflict of interest statement
Declaration of Competing Interest Ali A. Asadi-Pooya: Honoraria from Cobel Daruo, Ronak, and RaymandRad; Royalty: Oxford University Press (Book publication); Grant from the National Institute for Medical Research Development. Eugen Trinka has received personal fees from Arvelle/Angelini, Argenix, UCB, Eisai, Bial, Böhringer Ingelheim, Medtronic, Everpharma, Epilog, GSK, Biogen, Takeda, Liva-Nova, Newbridge, Novartis, Sanofi, Sandoz, Sunovion, GW Pharmaceuticals, Marinus; grants from Austrian Science Fund (FWF), Österreichische Nationalbank, European Union, GSK, Biogen, Eisai, Novartis, Red Bull, Bayer, and UCB; other from Neuroconsult Ges.m.b.H., outside this work. Simona Lattanzi has received speaker's or consultancy fees from Angelini, Eisai, GW Pharmaceuticals, and UCB Pharma, and has served on advisory boards for Angelini, Arvelle Therapeutics, Bial, EISAI, and GW Pharmaceuticals. Abdulaziz Ashkanani: Honoraria as a consultant/advisor & speaker for Novartis, Eli Lilly, NewBridge, and Hikma Co. Mansur Kutlubaev has received speaker's fees from Eisai. Yamile Calle-López has received fees as a speaker from UCB Pharma. Others: none.
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