Evidence map›Paper›PMID 26643546›Full record

ArticleNeurology2016

Disparities in surgery among patients with intractable epilepsy in a universal health system.

Jorge G Burneo, Salimah Z Shariff, Kuan Liu, Sean Leonard, Gustavo Saposnik, Amit X Garg

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

34 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  12. Treatment gaps in epilepsy.Frontiers in epidemiology · 2022
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Jorge G BurneoFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada. jburneo2@uwo.ca.
Salimah Z ShariffFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.
Kuan LiuFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.
Sean LeonardFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.
Gustavo SaposnikFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.
Amit X GargFrom the Epilepsy Program (J.G.B.), London Health Sciences Centre and Western University; the Institute for Clinical Evaluative Sciences (ICES) (S.Z.S., K.L., S.L., G.S., A.X.G.), Toronto; the Division of Neurology (G.S.), St Michael's Hospital, Toronto, Canada; the Department of Neuroeconomics (G.S.), University of Zurich, Switzerland; and the Schulich School of Medicine and Dentistry (A.X.G.), Western University, London, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the use of epilepsy surgery in patients with medically intractable epilepsy in a publicly funded universal health care system.

methodsWe performed a population-based retrospective cohort study using linked health care databases for Ontario, Canada, between 2001 and 2010. We identified all patients with medically intractable epilepsy, defined as those with seizures that did not respond to at least 2 adequate trials of seizure medications. We assessed the proportion of patients who had epilepsy surgery within the following 2 years. We further identified the characteristics associated with epilepsy surgery.

resultsA total of 10,661 patients were identified with medically intractable epilepsy (mean age 47 years, 51% male); most (74%) did not have other comorbidities. Within 2 years of being defined as medically intractable, only 124 patients (1.2%) underwent epilepsy surgery. Death occurred in 12% of those with medically intractable epilepsy. Those who underwent the procedure were younger and had fewer comorbidities compared to those who did not.

conclusionIn our setting of publicly funded universal health care, more than 10% of patients died within 2 years of developing medically intractable epilepsy. Epilepsy surgery may be an effective treatment for some patients; however, fewer than 2% of patients who may have benefited from epilepsy surgery received it.

Indexed as

Healthcare DisparitiesNeurosurgical ProceduresUniversal Health InsuranceAdultAgedCohort StudiesDrug Resistant EpilepsyFemaleHumansMaleMiddle AgedOntarioRetrospective StudiesTreatment Outcome

Identifiers

PMID26643546
PMCPMC4731294

What OpenQuestion holds

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Registered trials

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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.