中低收入国家(LMICs)功能神经外科的现状:基于多国横断面调查的接触、利用和感知障碍分析

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY
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引用次数: 0

摘要

导言功能神经外科(FNS)是一种无创、高效的神经外科亚专科,但中低收入国家(LMIC)在获得和利用 FNS 方面处于劣势。通过这项研究,我们试图评估五种主要 FNS 方式(包括脑深部刺激 (DBS)、迷走神经刺激 (VNS)、立体定向放射外科 (SRS)、磁共振成像引导下聚焦超声 (MRgfUS) 和经皮根治术)在中低收入国家/地区的可用性、接触、利用和感知障碍。我们从低收入国家的执业神经外科医生、神经外科研究员和住院医师中收集了回复。使用 SPSS 软件 26.0 进行了统计分析。68%的受访者在教育机构工作。受访者接触最多的是 SRS(36%),其次是 DBS(28%),而接触最少的是 MRgFUS(4%)(p<0.001)。除 MRgFUS 外,大多数受访者对所有治疗方式都 "相当有信心"(p<0.001)。在统计意义上,没有观察到各种模式的可用性与工作设置类型有明显关联。大多数受访者并不认为法律问题(p=0.003)和患者偏好(p=0.007)是任何模式的障碍。除了 DBS(分别为 52%,p<0.001;55%,p<0.001 和 53%,p=0.002)之外,可及性、可负担性和缺乏培训对任何方式都不是重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Status of functional neurosurgery in lower middle-income countries (LMICs): A multinational cross sectional survey based analysis of exposure, utilization and perceived barriers

Introduction

Functional Neurosurgery (FNS) is a non-invasive and highly efficacious neurosurgical subspecialty but lower middle-income countries (LMICs) are disadvantaged in terms of access and availability of FNS. Through this study we have tried to assess the availability, exposure, utilization, and perceived barriers to five major FNS modalities including deep brain stimulation (DBS), vagal nerve stimulation (VNS), stereotactic radiosurgery (SRS), MRI-guided focused ultrasound (MRgfUS) and percutaneous rhizotomy in LMICs.

Methodology

We designed a survey using google forms while following the CHERRIES guidelines. Responses were collected from practicing neurosurgeons, neurosurgical fellows, and residents in LMICs. Statistical analysis was performed using SPSS software 26.0

Results

A total of 100 responses were recorded of which 96 % were males. 68 % worked in an educational setup. Respondents had the most exposure to SRS (36 %) followed by DBS (28 %) while MRgFUS was the least exposed modality (4 %) (p<0.001). For all modalities except MRgFUS, majority of the respondents were ‘Fairly confident’ (p<0.001). No statistically significant association was observed in the availability of the modalities with the type of working setup. Majority of the respondents did not consider legal issues (p=0.003) and patient preferences (p=0.007) to be perceived barriers for any modality. Accessibility, affordability, Lack of training were not significant factors for any modality except DBS (52 %, p<0.001; 55 %, p<0.001 and 53 %, p=0.002 respectively)

Conclusion

An integrated approach including international collaborations, traveling fellowships, novel policies must be adopted to enhance the reach of FNS to LMICs to share the extensive neurosurgical burden and to ease the neurosurgical decision making.

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来源期刊
Clinical Neurology and Neurosurgery
Clinical Neurology and Neurosurgery 医学-临床神经学
CiteScore
3.70
自引率
5.30%
发文量
358
审稿时长
46 days
期刊介绍: Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.
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