Abstract:
:OBJECT Neurosurgery studies traditionally have evaluated the effects of interventions on health care outcomes by studying overall changes in measured outcomes over time. Yet, this type of linear analysis is limited due to lack of consideration of the trend's effects both pre- and postintervention and the potential for confounding influences. The aim of this study was to illustrate interrupted time-series analysis (ITSA) as applied to an example in the neurosurgical literature and highlight ITSA's potential for future applications. METHODS The methods used in previous neurosurgical studies were analyzed and then compared with the methodology of ITSA. RESULTS The ITSA method was identified in the neurosurgical literature as an important technique for isolating the effect of an intervention (such as a policy change or a quality and safety initiative) on a health outcome independent of other factors driving trends in the outcome. The authors determined that ITSA allows for analysis of the intervention's immediate impact on outcome level and on subsequent trends and enables a more careful measure of the causal effects of interventions on health care outcomes. CONCLUSIONS ITSA represents a significant improvement over traditional observational study designs in quantifying the impact of an intervention. ITSA is a useful statistical procedure to understand, consider, and implement as the field of neurosurgery evolves in sophistication in big-data analytics, economics, and health services research.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Wong RH,Smieliauskas F,Pan IW,Lam SKdoi
10.3171/2015.9.FOCUS15374subject
Has Abstractpub_date
2015-12-01 00:00:00pages
E6issue
6issn
1092-0684journal_volume
39pub_type
杂志文章abstract::There is growing evidence to suggest that pregnancy may increase the risk of hemorrhage from cavernous malformations (CMs). In the present case, a 21-year-old primigravida was admitted to the authors' neurosurgical service after a cesarean section. Three weeks before admission she had experienced rapidly progressive b...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2006.21.1.13
更新日期:2006-07-15 00:00:00
abstract::OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FOCUS17733
更新日期:2018-04-01 00:00:00
abstract::There has been increasing awareness that glioblastoma, which may seem histopathologically similar across many tumors, actually represents a group of molecularly distinct tumors. Emerging evidence suggests that cells even within the same tumor exhibit wide-ranging molecular diversity. Parallel to the discoveries of mol...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.9.FOCUS14521
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Nonfunctioning pituitary adenomas present without biochemical or clinical signs of hormone excess and are the second most common type of pituitary adenomas. The 2017 WHO classification scheme of pituitary adenomas differentiates null-cell adenomas (NCAs) and silent gonadotroph adenomas (SGAs). The present stu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.3.FOCUS20114
更新日期:2020-06-01 00:00:00
abstract::OBJECTIVE The American Association of Neurological Surgeons launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data, to measure the safety and quality of neurosurgical procedures, including spinal surgery. Differing ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.10.FOCUS17553
更新日期:2018-01-01 00:00:00
abstract:OBJECT:Arachnoid cysts are commonly encountered fluid collections in the central nervous system. Recent advances in neuroimaging have translated into an increased detection of these cysts; that is, diagnoses can be made more frequently at earlier stages. Significant advances have also been made in the surgical manageme...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.2.7
更新日期:2007-02-15 00:00:00
abstract:OBJECT:Chordomas have a high propensity for local recurrence and progression, as well as for systemic and cerebrospinal fluid metastasis. The authors identified and analyzed a series of patients with chordomas, focusing on an underrecognized entity--surgical seeding. METHODS:In a retrospective analysis of 82 patients ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2001-03-15 00:00:00
abstract::Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyoge...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-06-15 00:00:00
abstract::A 29-year-old woman is diagnosed with a large broad-base right ophthalmic artery aneurysm. Despite an intact visual field, she complained of mild right visual blurriness. Between endovascular and surgical treatments, surgery was favored due to her young age. It was decided to perform the surgery with simultaneous endo...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.7.FocusVid.14570
更新日期:2015-07-01 00:00:00
abstract::In this article, the author provides a brief description of the role of hypoxia in the tumorigenesis of gliomas and suggests potential ways of exploiting this role to design treatment modalities. Tumor hypoxia predicts the likelihood of metastases, tumor recurrence, resistance to chemotherapy and radiation therapy, in...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.4.16
更新日期:2006-04-15 00:00:00
abstract::Hypothalamic hamartomas (HHs) are developmental malformations associated with a range of neurological problems, including intractable seizures. There is increasing evidence of the epileptogenicity of the hamartoma and of the inhomogeneous distribution of the epileptic abnormalities within the malformation. The managem...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.11.FOCUS10241
更新日期:2011-02-01 00:00:00
abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19441
更新日期:2019-10-01 00:00:00
abstract::Stereotactic radiosurgery (SRS) with the Gamma Knife and linear accelerator has revolutionized neurosurgery over the past 20 years. The most common indications for radiosurgery today are tumors and arteriovenous malformations of the brain. Functional indications such as treatment of movement disorders or intractable p...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/12/E3
更新日期:2007-01-01 00:00:00
abstract::OBJECT The relative benefit of repeat surgery for recurrent glioblastoma is unclear, in part due to the very heterogeneous nature of the patient population and the effect of clinician philosophy on the duration and aggressiveness of treatment. The authors sought to investigate the role of time to last recurrence on pa...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.12.FOCUS14726
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:The COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic. METHODS:Between May 7, 2020, and May 16, 2020, a validated questionn...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.9.FOCUS20537
更新日期:2020-12-01 00:00:00
abstract::Arteriovenous malformation (AVM) presenting with epilepsy significantly impacts patient quality of life, and it should be considered very much a seizure disorder. Although hemorrhage prevention is the primary treatment aim of AVM surgery, seizure control should also be at the forefront of therapeutic management. Sever...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.1.FOCUS19899
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be consider...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.12.FOCUS19448
更新日期:2020-03-01 00:00:00
abstract::Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.4.7
更新日期:2003-10-15 00:00:00
abstract::The surgical management of intramedullary spinal cord ependymomas remains a formidable challenge amongst neurosurgeons because of the potential risk of surgical morbidity. From on an oncological perspective, complete resection-if technically feasible-should be the goal of surgery, since this can result in excellent lo...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.V2.FOCUS12142
更新日期:2012-07-01 00:00:00
abstract::Brain-machine interface (BMI) is the latest solution to a lack of control for paralyzed or prosthetic limbs. In this paper the authors focus on the design of anatomical robotic hands that use BMI as a critical intervention in restorative neurosurgery and they justify the requirement for lower-level neuromusculoskeleta...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.20.5.4
更新日期:2006-05-15 00:00:00
abstract::Since its inception, one of the major issues in transsphenoidal surgery has been the adequate visualization of anatomical structures. As transsphenoidal surgery evolved, technical advancements improved the surgical view of the operative field and the orientation. The operating microscope replaced Cushing's headlight a...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章,评审
doi:10.3171/foc.2005.19.6.4
更新日期:2005-12-15 00:00:00
abstract::Glossopharyngeal neuralgia (GPN) is an uncommon facial pain syndrome often misdiagnosed as trigeminal neuralgia. The rarity of this condition and its overlap with other cranial nerve hyperactivity syndromes often leads to a significant delay in diagnosis. The surgical procedures with the highest rates of pain relief f...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.12.FOCUS12391
更新日期:2013-03-01 00:00:00
abstract::OBJECTIVE Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical c...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1850
更新日期:2018-06-01 00:00:00
abstract::The development of less invasive methods to evacuate intracerebral hematomas (ICHs) has improved outcome in patients with traumatic brain injury. Eighteen patients with ICHs underwent surgery via one of two methods: stereotactic endoscopic removal (SER) or stereotactic catheter drainage (SCD). The outcome results were...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.4.2
更新日期:1996-10-15 00:00:00
abstract::The most commonly accepted indications for cervical disc arthroplasty (CDA) are 1- and 2-level cervical disc herniation or spondylosis causing radiculopathy or myelopathy that is refractory to medical management. Unlike anterior cervical discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the ph...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.1.FocusVid.16380
更新日期:2017-01-01 00:00:00
abstract:OBJECT:Anterior cervical discectomy (ACD) is an effective and safe treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Cervical interbody fusion allows preservation of the physiological lordosis and stability of the cervical spine. Based on data reported in the literature, fusi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.1.4
更新日期:2002-01-15 00:00:00
abstract::The widespread use of fusion procedures in the management of spinal disorders has led investigators to explore the use of growth and differentiation factors in such procedures. As an adjuvant to allograft bone or as a replacement for harvested autograft, bone morphogenetic proteins (BMPs) appear to improve fusion rate...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2001.10.4.4
更新日期:2001-04-15 00:00:00
abstract::OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.8.FOCUS18268
更新日期:2018-11-01 00:00:00
abstract::The ability of diffusion tensor MRI to detect the preferential diffusion of water in cerebral white matter tracts enables neurosurgeons to noninvasively visualize the relationship of lesions to functional neural pathways. Although viewed as a research tool in its infancy, diffusion tractography has evolved into a neur...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.11.FOCUS19785
更新日期:2020-02-01 00:00:00
abstract::Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15466
更新日期:2016-01-01 00:00:00