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The outcome of any hypothesis testing leads to rejecting or not rejecting the null hypothesis. This decision is taken based on the analysis of the data, an appropriate test statistic, an appropriate confidence level, the critical values, and P-values. However, when the evidence suggests that the null hypothesis cannot be rejected, is it right to say, 'Accept' the null hypothesis?
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Related Experiment Video

Updated: May 4, 2026

Preparing Undercut Model of Posttraumatic Epileptogenesis in Rodents
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Why is there still doubt to cut it out?

J Engel1

  • 1Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Epilepsy Currents
|December 19, 2013
PubMed
Summary

Epilepsy surgery offers better outcomes but remains underutilized. Increasing patient access to specialized epilepsy centers is crucial for improving care and reducing long-term disability.

Area of Science:

  • Neurology
  • Neurosurgery
  • Medical Interventions

Background:

  • Epilepsy surgery has advanced significantly due to improved neuroimaging and surgical techniques, leading to better seizure control and quality of life.
  • Despite advancements, epilepsy surgery is underutilized, with less than 1% of pharmacoresistant epilepsy patients in the US being referred for surgical evaluation.
  • A significant delay exists between epilepsy onset and surgical intervention, often exceeding 20 years, potentially leading to irreversible disability.

Purpose of the Study:

  • To highlight the underutilization of epilepsy surgery despite its proven benefits.
  • To identify barriers to surgical referral and treatment for patients with pharmacoresistant epilepsy.
  • To advocate for increased access to specialized epilepsy centers for comprehensive evaluation and treatment.

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Main Methods:

  • Review of current trends in epilepsy surgery, neurodiagnostics, and surgical techniques.
  • Analysis of referral patterns and delays in surgical treatment for epilepsy patients.
  • Discussion of existing controversies and recommendations for improving access and standards of care.

Main Results:

  • Epilepsy surgery outcomes have improved, yet the number of procedures has not increased, indicating a significant gap in patient access.
  • Neurologists and primary care physicians lack consistent messaging to refer patients, contributing to underutilization.
  • Delays in referral and treatment prolong disability and increase mortality risk for epilepsy patients.

Conclusions:

  • Increased access to epilepsy surgery facilities and specialized epilepsy centers is paramount for improving patient outcomes.
  • Establishing consensus and standards for presurgical evaluation and surgical approaches is necessary.
  • Promoting comprehensive epilepsy centers that offer a range of services beyond surgery is essential for holistic patient care.