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How does research activity align with research need in chronic subdural haematoma: a gap analysis of systematic

Conor S Gillespie1,2, Kwan Wai Fung3, Ali M Alam4

  • 1Department of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, CB2 0SZ, Cambridge, UK. conorgillespie1@gmail.com.

Acta Neurochirurgica
|May 30, 2023
PubMed

Insights

Existing systematic reviews inadequately address critical questions for chronic subdural haematoma (CSDH) care. New research is needed to develop comprehensive clinical guidelines for this increasingly common condition, improving patient outcomes.

Area of Science:

  • Neurosurgery
  • Gerontology
  • Evidence-based medicine

Background:

  • Chronic subdural haematoma (CSDH) is a growing concern, necessitating a multi-disciplinary approach beyond neurosurgery.
  • Optimizing CSDH care requires addressing patient complexity and peri-operative morbidity.
  • The Improving Care in Elderly Neurosurgery Initiative (ICENI) aims to create the first comprehensive UK clinical practice guideline for CSDH.

Approach:

  • Identified 44 critical research questions for CSDH care through multi-stakeholder workshops.
  • Conducted an umbrella review of systematic reviews and meta-analyses on CSDH, adhering to PRISMA guidelines.
  • Assessed the quality of 73 included systematic reviews using AMSTAR-2 criteria.

Key Points:

  • Current literature largely focuses on surgical complications and recurrence, neglecting key ICENI themes.
  • A significant proportion of existing reviews (65.8%) had critically low quality ratings.
  • Review duplication was common, indicating inefficient research efforts.

Conclusions:

  • Existing systematic reviews do not sufficiently address the critical research questions for CSDH.
  • New systematic reviews are urgently required to inform a comprehensive CSDH clinical practice guideline.
  • Research efforts must be redirected to align with service organization and patient needs in CSDH care.
Abstract

Keywords:
AMSTARChronic subdural haematomaICENIPRISMAReporting qualityUmbrella review

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