ArticleEpilepsy & behavior : E&B2021
Underutilization of epilepsy surgery: Part I: A scoping review of barriers.
Article in Epilepsy & behavior : E&B, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses 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.
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Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Barriers to care in epilepsy surgery clinics in Latin America: a systematic review of social-economic impact.Neurosurgical review · 2026Pooled it
- Surgical Treatments for Epilepsies in Children Aged 1-36 Months: A Systematic Review.Neurology · 2023Pooled it
- Parental experience and decision-making for epilepsy surgery: A systematic review of qualitative and quantitative studies.Epilepsy & behavior : E&B · 2021Pooled it
- Healthcare professionals' knowledge, attitude, and perception of epilepsy surgery: A systematic review.Epilepsy & behavior : E&B · 2021Pooled it
- Prepare, don't scare: Rethinking cognitive readiness before epilepsy surgery.Epilepsia open · 2026Article
- Article
- Stem cell-based therapeutics in epilepsy: current advances and future prospects.Stem cells translational medicine · 2026Review
- Unsupervised clustering of electroclinical features in temporal lobe epilepsy: A data-driven approach.Epileptic disorders : international epilepsy journal with videotape · 2026Article
- Epilepsy Surgery in a Resource-Limited Latin-American Center: Presurgical Evaluation Findings and Early ILAE Outcomes in a Mixed Adult-Pediatric Cohort.Brain sciences · 2026Article
- Delayed and deferred surgery associated with cenobamate use in people with drug-resistant focal epilepsy.Epilepsia · 2026Article
- A Study on Protocol-based Treatment Change in Drug-resistant Epilepsy Patients in a Tertiary Care Center in Eastern India.Annals of Indian Academy of Neurology · 2026Article
- Initial negative imaging in GATOR1-associated genetic epilepsy does not preclude the existence of a focal, resectable epileptogenic zone: illustrative cases.Journal of neurosurgery. Case lessons · 2026Article
- Beyond Broca and Wernicke: Epilepsy surgery in the language areas.Epileptic disorders : international epilepsy journal with videotape · 2026Review
- Expanding the scope of pediatric epilepsy surgery: Access, indications, and outcomes in a modern cohort.Epilepsia open · 2026Article
- Factors Limiting Access to Surgical Treatment of Focal Epilepsy in Kazakh Population.International journal of environmental research and public health · 2026Observational
- Implementation of a ketogenic diet clinic in Mexico: A pilot program in a resource-limited setting.Epilepsy & behavior reports · 2026Article
- Normalization of deviance in neuromodulation for epilepsy.Epilepsia · 2026Review
- Assessing Knowledge and Awareness of Epilepsy Surgery in Healthcare Students and Interns at King Abdulaziz University.Behavioural neurology · 2026Article
- Twenty years of frontal lobe surgery: Clinical outcomes and lessons from the frontier.Surgical neurology international · 2026Article
- Hemispherotomy for Drug-Resistant Epilepsy in a Low-Resource Setting: Surgical Outcomes and Quality of Life in 23 Children Treated in a Hybrid Program in Panama.Pediatric neurosurgery · 2026Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
One-third of persons with epilepsy have seizures despite appropriate medical therapy. Drug resistant epilepsy (DRE) is associated with neurocognitive and psychological decline, poor quality of life, increased risk of premature death, and greater economic burden. Epilepsy surgery is an effective and safe treatment for a subset of people with DRE but remains one of the most underutilized evidence-based treatments in modern medicine. The reasons for this quality gap are insufficiently understood. In this comprehensive review, we compile known significant barriers to epilepsy surgery, originating from both patient/family-related factors and physician/health system components. Important patient-related factors include individual and epilepsy characteristics which bias towards continued preferential use of poorly effective medications, as well as patient perspectives and misconceptions of surgical risks and benefits. Health system and physician-related barriers include demonstrable knowledge gaps among physicians, inadequate access to comprehensive epilepsy centers, complex presurgical evaluations, insufficient research, and socioeconomic bias when choosing appropriate surgical candidates.
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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.