SynthesisNeurosurgery2020
Neurosurgical Randomized Trials in Low- and Middle-Income Countries.
Synthesis in Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The efficacy of surgical interventions for trigeminal neuralgia in multiple sclerosis: A systematic review.Neurosurgical review · 2026Pooled it
- Global disparities in neurosurgical literature: a narrative review of underrepresentation of low- and middle-income countries and pathways to research equity.Annals of medicine and surgery (2012) · 2026Article
- Beyond the bone flap: integrating biomarkers, imaging, and emerging technologies in the surgical continuum of acute subdural hematoma (ASDH).Annals of medicine and surgery (2012) · 2026Review
- The top 100 most cited peer-reviewed publications on global neurosurgery: Mapping research trends and gaps over four decades.Acta neurochirurgica · 2026Review
- The current landscape of United States global neurosurgery scholarly work: gaps and opportunities.Acta neurochirurgica · 2026Review
- Current status of neurotrauma management in resource-limited settings.Annals of medicine and surgery (2012) · 2025Review
- Global Neurosurgery: A Path Forward Through Health System Strengthening.Neurosurgery · 2025Review
- The Work is Never Done.Acta medica Philippina · 2025Article
- Guidelines in Neurosurgery: a critical appraisal.Acta neurochirurgica · 2024Review
- The availability, access, challenges and advancements in neurosurgical care in Africa: a mini review.Annals of medicine and surgery (2012) · 2024Review
- The application of medical ethics in the developing countries - A neurosurgical perspective.Brain & spine · 2024Review
- Letter to the Editor: Awake craniotomies in South America: Advancements, challenges, and future prospects.Journal of central nervous system disease · 2024Article
- Glioblastoma management in a lower middle-income country: Nationwide study of compliance with standard care protocols and survival outcomes in Ukraine.Neuro-oncology practice · 2023Article
- Research trends within aneurysmal subarachnoid hemorrhage from 2017 to 2021: a bibliometric study.Neurosurgical review · 2023Article
- Managing Severe Traumatic Brain Injury Across Resource Settings: Latin American Perspectives.Neurocritical care · 2023Article
- The current state of global contribution to open access publishing in neurosurgery: A bibliometric analysis.Brain & spine · 2023Article
- Providing Neurocritical Care in Resource-Limited Settings: Challenges and Opportunities.Neurocritical care · 2022Review
- The Application of Guideline-Based Care for Traumatic Brain and Spinal Cord Injury in Low- and Middle-Income Countries: A Provider-Based Survey.World neurosurgery: X · 2022Article
- Neurosurgical training in the Caribbean.Brain & spine · 2022Article
- Effects of socio-economic factors on research over systemic sclerosis: an analysis based on long time series of bibliometric data.Orphanet journal of rare diseases · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
backgroundThe setting of a randomized trial can determine whether its findings are generalizable and can therefore apply to different settings. The contribution of low- and middle-income countries (LMICs) to neurosurgical randomized trials has not been systematically described before.
objectiveTo perform a systematic analysis of design characteristics and methodology, funding source, and interventions studied between trials led by and/or conducted in high-income countries (HICs) vs LMICs.
methodsFrom January 2003 to July 2016, English-language trials with >5 patients assessing any one neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library. Income classification for each country was assessed using the World Bank Atlas method.
resultsA total of 73.3% of the 397 studies that met inclusion criteria were led by HICs, whereas 26.7% were led by LMICs. Of the 106 LMIC-led studies, 71 were led by China. If China is excluded, only 8.8% were led by LMICs. HIC-led trials enrolled a median of 92 patients vs a median of 65 patients in LMIC-led trials. HIC-led trials enrolled from 7.6 sites vs 1.8 sites in LMIC-led studies. Over half of LMIC-led trials were institutionally funded (54.7%). The majority of both HIC- and LMIC-led trials evaluated spinal neurosurgery, 68% and 71.7%, respectively.
conclusionWe have established that there is a substantial disparity between HICs and LMICs in the number of published neurosurgical trials. A concerted effort to invest in research capacity building in LMICs is an essential step towards ensuring context- and resource-specific high-quality evidence is generated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.