Evidence map›Paper›PMID 41931042›Full record

ArticleEpilepsia2026

Clinician knowledge gaps in epilepsy surgery: An international survey across 18 countries or regions in Asia-Oceania.

Parthvi Ravat, Si-Lei Fong, Jasmine Parihar, Vigneswaran Veeramuthu, Surabhi Garg, Yukako Nakagami, Shuli Liang, Jing Peng, Chen Chen, Muhammad Akil Yerilwan Putra and 7 more

Abstract read
In one paragraph

Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

17 authors.

Parthvi RavatYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0001-9548-8704
Si-Lei FongYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0003-1217-6380
Jasmine PariharYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0002-5545-4304
Vigneswaran VeeramuthuYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0003-2052-0858
Surabhi GargYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0002-1492-5237
Yukako NakagamiYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0001-7495-8957
Shuli LiangDepartment of Functional Neurosurgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.ORCID https://orcid.org/0000-0002-7292-745X
Jing PengDepartment of Pediatrics, Xiangya Hospital of Central South University, Changsha, China.ORCID https://orcid.org/0000-0002-7804-0622
Chen ChenYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0002-2672-5013
Muhammad Akil Yerilwan PutraYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0001-8232-839X
Atiwat SoontornpunYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0002-8477-864X
Katrina Bianca MantosYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0009-0007-9403-0401
Minh-An Thuy LeYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0001-9658-6453
Chia-Yen LinYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0003-2648-099X
Mayur ThakkarDepartment of Neurology, Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, India.ORCID https://orcid.org/0000-0003-4215-8802
Ajay AsrannaYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0002-8242-7248
Naoto KurodaYoung Epilepsy Section Asia-Oceania (YES-AO), the regional chapter of the Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES) in the Asia-Oceania region.ORCID https://orcid.org/0000-0003-1977-4893

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study was undertaken to assess clinicians' knowledge of epilepsy surgery across Asia-Oceania and identify individual- and country- or region-level factors associated with this knowledge, to inform strategies addressing the epilepsy surgery treatment gap.

methodsWe conducted a multinational, cross-sectional, web-based survey of clinicians involved in epilepsy care across 18 countries or regions in Asia-Oceania (May-September 2024). The primary outcome was an epilepsy surgery knowledge score (range = 0-12), derived from 12 multiple-choice items covering indications for surgery, referral timing, understanding of surgical procedures, misconceptions about antiseizure medication efficacy, and perceived contraindications (e.g., electroencephalographic/magnetic resonance imaging findings, eloquent cortex, memory risk, psychiatric comorbidity, and intellectual disability). Linear mixed-effects models were used to identify individual-level predictors of knowledge, with country or region modeled as a random intercept. Ancillary analyses examined correlations between country- or region-level knowledge effects and academic activity related to epilepsy.

resultsA total of 809 clinicians were included, with respondents primarily from India (n = 204), China (n = 194), and Japan (n = 93). The mean knowledge score was 7.3 ± 2.9, with item-level correct response rates ranging from 11.2% to 87.6%. Higher knowledge was independently associated with being an epileptologist or neurosurgeon, working at a center with an epilepsy surgery program, and higher epilepsy case volume. Lower knowledge was observed among clinicians outside core neurological specialties. Significant country- or region-level variation persisted after adjustment and correlated with national academic activity in epilepsy surgery and epilepsy awareness. SIGNIFICANCE: Clinician knowledge of epilepsy surgery varies substantially across Asia-Oceania. Although targeted education is necessary, structural factors such as the availability of epilepsy surgery programs and national academic engagement also appear critical for translating knowledge into access. Multilevel strategies that integrate education with health-system strengthening are needed to meaningfully reduce the epilepsy surgery knowledge and treatment gaps.

Indexed as

Clinical CompetenceEpilepsyHealth Knowledge, Attitudes, PracticeNeurosurgical ProceduresAdultAsiaCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesAsia–Oceaniaepilepsy surgeryhealth disparitiesIntersectoral Global Action Plan (IGAP)WHO

Identifiers

PMID41931042
PMCPMC13360989

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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.