Evidence map›Paper›PMID 26250432›Full record

ArticleEpilepsia2015

The evolution of epilepsy surgery between 1991 and 2011 in nine major epilepsy centers across the United States, Germany, and Australia.

Lara Jehi, Daniel Friedman, Chad Carlson, Gregory Cascino, Sandra Dewar, Christian Elger, Jerome Engel, Robert Knowlton, Ruben Kuzniecky, Anne McIntosh and 8 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 147 citations in OpenAlex.

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  18. The changing landscape in epilepsy imaging: Unmasking subtle and unique entities.Diagnostic and interventional radiology (Ankara, Turkey) · 2022
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 7 institutions in 3 countries.

Lara JehiDepartment of Neurology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Daniel FriedmanDepartment of Neurology, New York University, New York, New York, U.S.A.
Chad CarlsonDepartment of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
Gregory CascinoDepartment of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Sandra DewarDepartment of Neurology, University of California-Los Angeles, Los Angeles, California, U.S.A.
Christian ElgerDepartment of Neurology, University of Bonn, Bonn, Germany.
Jerome EngelDepartment of Neurology, University of California-Los Angeles, Los Angeles, California, U.S.A.
Robert KnowltonDepartment of Neurology, University of California-San Francisco, San Francisco, California, U.S.A.
Ruben KuznieckyDepartment of Neurology, New York University, New York, New York, U.S.A.
Anne McIntoshThe Department of Medicine, The Royal Melbourne and Austin Hospitals, University of Melbourne, Melbourne, Victoria, Australia.
Terence J O'BrienThe Department of Medicine, The Royal Melbourne and Austin Hospitals, University of Melbourne, Melbourne, Victoria, Australia.
Dennis SpencerDepartment of Neurology, Yale University, New Haven, Connecticut, U.S.A.
Michael R SperlingDepartment of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Gregory WorrellDepartment of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Bill BingamanDepartment of Neurology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Jorge Gonzalez-MartinezDepartment of Neurology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Werner DoyleDepartment of Neurology, New York University, New York, New York, U.S.A.
Jacqueline FrenchDepartment of Neurology, New York University, New York, New York, U.S.A.
Cleveland Clinic · USAustin Hospital · AUMayo Clinic · USThomas Jefferson University · USUniversity of Bonn · DEUniversity of California, San Francisco · USYale University · US

Funding

IN VIVO STUDIES OF THE EPILEPTIC HIPPOCAMPUSR01NS033310 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JEROME NONE ENGEL, Richard Staba · 1994 to 2026
$7.5M
IN VIVO STUDIES OF THE EPILEPTIC HIPPOCAMPUSR37NS033310 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ENGEL, JEROME NONE · 2004 to 2010
$3.2M
NINDS NIH HHS R01 NS033310NINDS NIH HHS R37 NS033310
6 · The paper itself

Abstract

objectiveEpilepsy surgery is the most effective treatment for select patients with drug-resistant epilepsy. In this article, we aim to provide an accurate understanding of the current epidemiologic characteristics of this intervention, as this knowledge is critical for guiding educational, academic, and resource priorities.

methodsWe profile the practice of epilepsy surgery between 1991 and 2011 in nine major epilepsy surgery centers in the United States, Germany, and Australia. Clinical, imaging, surgical, and histopathologic data were derived from the surgical databases at various centers.

resultsAlthough five of the centers performed their highest number of surgeries for mesial temporal sclerosis (MTS) in 1991, and three had their highest number of MTS surgeries in 2001, only one center achieved its peak number of MTS surgeries in 2011. The most productive year for MTS surgeries varied then by center; overall, the nine centers surveyed performed 48% (95% confidence interval [CI] -27.3% to -67.4%) fewer such surgeries in 2011 compared to either 1991 or 2001, whichever was higher. There was a parallel increase in the performance of surgery for nonlesional epilepsy. Further analysis of 5/9 centers showed a yearly increase of 0.6 ± 0.07% in the performance of invasive electroencephalography (EEG) without subsequent resections. Overall, although MTS was the main surgical substrate in 1991 and 2001 (proportion of total surgeries in study centers ranging from 33.3% to 70.2%); it occupied only 33.6% of all resections in 2011 in the context of an overall stable total surgical volume. SIGNIFICANCE: These findings highlight the major aspects of the evolution of epilepsy surgery across the past two decades in a sample of well-established epilepsy surgery centers, and the critical current challenges of this treatment option in addressing complex epilepsy cases requiring detailed evaluations. Possible causes and implications of these findings are discussed.

Indexed as

Treatment OutcomeAdolescentAdultAustraliaEpilepsyFemaleGermanyHumansMagnetic Resonance ImagingMaleMiddle AgedNeurosurgical ProceduresRetrospective StudiesUnited StatesYoung AdultEpilepsy surgeryInvasive EEGMesial temporal sclerosisNeocortical epilepsy

Identifiers

PMID26250432
PMCPMC5082694
OpenAlexW1567672817

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.