Advancing Evidence Quality and Reproducibility in Bypass in Neurosurgery Research: A Systematic Review and Reporting...

Area of Science:

• Neurosurgery
• Vascular Surgery
• Medical Reporting Standards

Background:

• Bypass surgery is crucial for complex intracranial aneurysms (IAs) and Moyamoya disease (MMD) when standard treatments fail.
• Existing literature on bypass surgery for IAs and MMD suffers from heterogeneity and poor reporting quality, hindering reproducibility.
• There is a need to evaluate current evidence and establish standardized reporting guidelines.

Purpose of the Study:

• To systematically review and assess the reporting quality of bypass surgery for IAs and MMD.
• To develop a comprehensive reporting guideline to enhance transparency, reproducibility, and methodological rigor in this field.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and Web of Science databases.
• Included studies were observational or randomized, published between 2000-2025, with ≥3 patients, reporting clinical/surgical outcomes.
• Assessment focused on 10 key domains, including patient characteristics, imaging, surgical details, outcomes, and conflicts of interest.

Main Results:

• Thirty studies met the inclusion criteria, revealing significant reporting deficiencies across all assessed domains.
• A novel bypass reporting guideline was developed, structured into 10 domains with a checklist for IA and MMD.
• The guideline stresses detailed technical reporting, graft patency, antithrombotic management, and standardized outcome measures.

Conclusions:

• Systematic review identified significant methodological and reporting limitations in bypass surgery for IA and MMD.
• The proposed reporting guideline offers a framework to improve evidence quality, transparency, and comparability.
• Implementing this guideline can strengthen the evidence base and ultimately improve patient care for complex cerebrovascular conditions.