Adherence in Evidence-Based Neurotrauma Guidelines: A Worldwide Survey

Area of Science:

• Neurosurgery
• Evidence-Based Medicine
• Global Health

Background:

• Traumatic brain injury (TBI) management guidelines lack global uniformity.
• Limited research exists on real-world adherence to TBI guidelines.
• A global survey was conducted to assess neurosurgeon adherence to TBI guidelines and evidence-based medicine (EBM).

Purpose of the Study:

• To evaluate neurosurgeons' adherence to established traumatic brain injury (TBI) guidelines.
• To assess the influence of evidence-based medicine (EBM) on TBI management globally.
• To identify regional variations in TBI treatment approaches.

Main Methods:

• A 24-item survey was distributed globally via Google Forms.
• The survey collected data on neurosurgeon demographics, training, EBM knowledge, and clinical management practices.
• Responses were analyzed from 233 neurosurgeons across 53 countries.

Main Results:

• 45% of neurosurgeons do not stay current with Brain Trauma Foundation guidelines.
• 48% prioritize personal experience over EBM guidelines, with significant regional disparities (Asia/Africa vs. Europe/Americas).
• 56% reported deviations from guidelines in neurotrauma management, including conservative treatment of significant hematomas and low GCS scores.

Conclusions:

• Neurosurgeons in Europe and the Americas demonstrate higher adherence to EBM guidelines.
• Neurosurgeons in Asia and Africa are more inclined to rely on individual clinical judgment.
• Significant variations in TBI management practices exist globally, highlighting a need for guideline dissemination and EBM integration.