gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Clinical trials in neurosurgery: how good are we?

Klinische Studien in der Neurochirurgie : wie gut sind wir eigentlich?

Meeting Abstract

Search Medline for

  • corresponding author K. Schöller - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • S. Licht - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • J.-C. Tonn - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München
  • E. Uhl - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-10.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0133.shtml

Published: May 4, 2005

© 2005 Schöller et al.
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Outline

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Objective

Health care decisions are increasingly being made on research-based evidence rather than on expert opinion or clinical experience alone. The strongest evidence in medical clinical literature is represented by the randomized controlled trial (RCT). The current study was designed to assess some modalities of internet-based literature search as well as quantity and quality of clinical neurosurgical literature with emphasis on RCT.

Methods

With the reference point set on 1/1/2004 we performed a literature search in the medical databases MEDLINE and EMBASE. Keywords were “neurosurgery” and “clinical trial”. Articles with topics not related to neurosurgery were excluded. Neurosurgical literature was subdivided into the following issues: “General neurosurgery”, “cranial”, “spinal”, and “peripheral nerves”. To find out about neurosurgeons' research activities, first authors', corresponding and senior authors' clinical specialization was reviewed in a next step. Thereafter, both databases were merged, identical manuscripts identified and all articles with the first, corresponding or senior author not being affiliated to a neurosurgical department removed. Then the remaining articles of both databases were evaluated whether the criteria for a randomized controlled trial were fulfilled or not.

Results

Initial search results for the keywords "neurosurgery" and "clinical trial" yielded 2936 counts in MEDLINE and 2730 counts in EMBASE, respectively. After exclusion of articles not clearly related to neurosurgery, 901 articles in the MEDLINE database and 1715 in the EMBASE database remained. After merging articles of both databases and excluding all articles not published under the responsibility of a neurosurgeon, a total number of 443 articles in Medline (49%) and 992 (58%) in EMBASE were left. Finally, 85 (9% of relevant literature) and 182 (11% of relevant literature) randomized controlled trials written by neurosurgeons could be identified in MEDLINE and EMBASE, respectively.

Conclusions

Searching for neurosurgical literature with the help of the internet databases MEDLINE and EMBASE yields a high number of studies primarily not related to neurosurgery. Furthermore, search results differ significantly between EMBASE and MEDLINE database. In most (MEDLINE) and many (EMBASE) cases, relevant literature covering neurosurgical topics was not written by neurosurgeons. Finally, randomized controlled trials account only for a fraction of the relevant neurosurgical literature.