SpringerLink
Log in

Beyond guidelines: analysis of current practice patterns of AANS/CNS tumor neurosurgeons

  • Topic Review
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Introduction

Evidence-based medicine guidelines are increasingly published and sanctioned by organized neurosurgery. However, implementation, interpretation, and use of clinical guidelines may vary substantially on a regional, national and international basis. Survey research can help bridge the gap by providing a snapshot of neurosurgeon attitudes, knowledge, and practices. The American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Section on Tumors formed a Survey Committee to formalize the process by which surveys are submitted and reviewed before distribution to our membership. The goal of this committee is to provide peer-review so that collected information will be scientifically robust and useful to the neurosurgical community.

Methods

Surveys submitted to the AANS/CNS tumor section between 2015 and 2019 were reviewed and metrics such as response rate and publication status assessed.

Results

Six surveys were submitted to the Survey Committee of the AANS/CNS section on tumors between 2015 and 2019. Four have been circulated to section members, of which three have been published. Response rate has averaged 19% (range 16–23%), a majority of respondents (mean 70%) practice in academic settings.

Conclusions

The AANS/CNS Section on Tumors Survey Committee has and continues to help promote and improve the practice of surveying our community to answer important questions that can advance future training, research, and practice. There remains significant room for improvement in response rates, but ongoing tumor section efforts to increase member engagement will likely improve these numbers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Vachhrajani S, Kulkarni AV, Kestle JRW (2009) Clinical practice guidelines. J Neurosurg Pediatr 3:249–256. https://doi.org/10.3171/2008.12.PEDS08278

    Article  PubMed  Google Scholar 

  2. Ducis K, Florman JE, Rughani AI (2016) Appraisal of the quality of neurosurgery clinical practice guidelines. World Neurosurg 90:322–339. https://doi.org/10.1016/j.wneu.2016.02.044

    Article  PubMed  Google Scholar 

  3. Pannullo SC, Ramakrishna R (2016) Neurosurgical guidelines in a medicolegal minefield. World Neurosurg 96:602–603. https://doi.org/10.1016/j.wneu.2016.05.026

    Article  PubMed  Google Scholar 

  4. Kelley K, Clark B, Brown V, Sitzia J (2003) Good practice in the conduct and reporting of survey research. Int J Qual Health Care 15:261–266. https://doi.org/10.1093/intqhc/mzg031

    Article  PubMed  Google Scholar 

  5. Cunningham CT, Quan H, Hemmelgarn B et al (2015) Exploring physician specialist response rates to web-based surveys. BMC Med Res Methodol 15:32. https://doi.org/10.1186/s12874-015-0016-z

    Article  PubMed  PubMed Central  Google Scholar 

  6. Braithwaite D, Emery J, De Lusignan S, Sutton S (2003) Using the Internet to conduct surveys of health professionals: a valid alternative? Fam Pract 20:545–551. https://doi.org/10.1093/fampra/cmg509

    Article  PubMed  Google Scholar 

  7. Burns KEA, Duffett M, Kho ME et al (2008) A guide for the design and conduct of self-administered surveys of clinicians. CMAJ 179:245–252. https://doi.org/10.1503/cmaj.080372

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ponto J (2015) Understanding and evaluating survey research. J Adv Pract Oncol 6:168–171

    PubMed  PubMed Central  Google Scholar 

  9. Dewan MC, Thompson RC, Kalkanis SN et al (2017) Prophylactic antiepileptic drug administration following brain tumor resection: results of a recent AANS/CNS section on tumors survey. J Neurosurg 126:1772–1778. https://doi.org/10.3171/2016.4.JNS16245

    Article  PubMed  Google Scholar 

  10. Wu AS, Trinh VT, Suki D et al (2013) A prospective randomized trial of peri-operative seizure prophylaxis in patients with intraparenchymal brain tumors. J Neurosurg 118:873–883. https://doi.org/10.3171/2012.12.JNS111970

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Chen CC, Rennert RC, Olson JJ (2019) Congress of neurological surgeons systematic review and evidence-based guidelines on the role of prophylactic anticonvulsants in the treatment of adults with metastatic brain tumors. Neurosurgery 84:E195–E197. https://doi.org/10.1093/neuros/nyy545

    Article  PubMed  Google Scholar 

  12. Siomin V, Angelov L, Li L, Vogelbaum MA (2005) Results of a survey of neurosurgical practice patterns regarding the prophylactic use of anti-epilepsy drugs in patients with brain tumors. J Neurooncol 74:211–215. https://doi.org/10.1007/s11060-004-6912-4

    Article  CAS  PubMed  Google Scholar 

  13. Lunsford LD, Chiang V, Adler JR et al (2012) A recommendation for training in stereotactic radiosurgery for US neurosurgery residents. J Neurosurg 117(Suppl):2–4. https://doi.org/10.3171/2012.6.GKS12838

    Article  PubMed  Google Scholar 

  14. Yang I, Udawatta M, Prashant GN et al (2019) Commentary: stereotactic radiosurgery training for neurosurgery residents: results of a survey of residents, attendings, and program directors by the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors. Neurosurgery 84:E86–E91. https://doi.org/10.1093/neuros/nyy514

    Article  PubMed  Google Scholar 

  15. Lacroix M, Abi-Said D, Fourney DR et al (2001) A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95:190–198. https://doi.org/10.3171/jns.2001.95.2.0190

    Article  CAS  PubMed  Google Scholar 

  16. Li YM, Suki D, Hess K, Sawaya R (2016) The influence of maximum safe resection of glioblastoma on survival in 1229 patients: can we do better than gross-total resection? J Neurosurg 124:977–988. https://doi.org/10.3171/2015.5.JNS142087

    Article  PubMed  Google Scholar 

  17. Sanai N, Polley M-Y, McDermott MW et al (2011) An extent of resection threshold for newly diagnosed glioblastomas. J Neurosurg 115:3–8. https://doi.org/10.3171/2011.2.JNS10998

    Article  PubMed  Google Scholar 

  18. Keles GE, Lundin DA, Lamborn KR et al (2004) Intraoperative subcortical stimulation map** for hemispherical perirolandic gliomas located within or adjacent to the descending motor pathways: evaluation of morbidity and assessment of functional outcome in 294 patients. J Neurosurg 100:369–375. https://doi.org/10.3171/jns.2004.100.3.0369

    Article  PubMed  Google Scholar 

  19. Oppenlander ME, Wolf AB, Snyder LA et al (2014) An extent of resection threshold for recurrent glioblastoma and its risk for neurological morbidity. J Neurosurg 120:846–853. https://doi.org/10.3171/2013.12.JNS13184

    Article  PubMed  Google Scholar 

  20. Stummer W, Reulen H-J, Meinel T et al (2008) Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery 62:564–576. https://doi.org/10.1227/01.neu.0000317304.31579.17(Discussion 564–576)

    Article  PubMed  Google Scholar 

  21. Baron RB, Kessler RA, Hadjipanayis CG (2019) Initial biopsy and early re-resection practices in the treatment of glioblastoma among AANS/CNS tumor section surgeons. J Neurooncol 144:529–534. https://doi.org/10.1007/s11060-019-03253-5

    Article  PubMed  Google Scholar 

  22. Sanai N, Mirzadeh Z, Berger MS (2008) Functional outcome after language map** for glioma resection. N Engl J Med 358:18–27. https://doi.org/10.1056/NEJMoa067819

    Article  CAS  PubMed  Google Scholar 

  23. Kombos T, Suess O, Kern BC et al (1999) Comparison between monopolar and bipolar electrical stimulation of the motor cortex. Acta Neurochir 141:1295–1301

    Article  CAS  Google Scholar 

  24. Solomon DA, Wood MD, Tihan T et al (2016) Diffuse midline gliomas with histone H3–K27M mutation: a series of 47 cases assessing the spectrum of morphologic variation and associated genetic alterations. Brain Pathol 26:569–580. https://doi.org/10.1111/bpa.12336

    Article  CAS  PubMed  Google Scholar 

  25. Lee J, Solomon DA, Tihan T (2017) The role of histone modifications and telomere alterations in the pathogenesis of diffuse gliomas in adults and children. J Neurooncol 132:1–11. https://doi.org/10.1007/s11060-016-2349-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Gupta N, Goumnerova LC, Manley P et al (2018) Prospective feasibility and safety assessment of surgical biopsy for patients with newly diagnosed diffuse intrinsic pontine glioma. Neuro Oncol 20:1547–1555. https://doi.org/10.1093/neuonc/noy070

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Catt S, Chalmers A, Fallowfield L (2008) Psychosocial and supportive-care needs in high-grade glioma. Lancet Oncol 9:884–891. https://doi.org/10.1016/S1470-2045(08)70230-4

    Article  PubMed  Google Scholar 

  28. Ford E, Catt S, Chalmers A, Fallowfield L (2012) Systematic review of supportive care needs in patients with primary malignant brain tumors. Neuro Oncol 14:392–404. https://doi.org/10.1093/neuonc/nor229

    Article  PubMed  PubMed Central  Google Scholar 

  29. Pompili A, Telera S, Villani V, Pace A (2014) Home palliative care and end of life issues in glioblastoma multiforme: results and comments from a homogeneous cohort of patients. Neurosurg Focus 37:E5. https://doi.org/10.3171/2014.9.FOCUS14493

    Article  PubMed  Google Scholar 

  30. Flanigan TS (2008) Conducting survey research among physicians and other medical professionals: a review of current literature. Proc Surv Res Methods Sect 12:4136–4147

    Google Scholar 

  31. VanGeest JB, Johnson TP, Welch VL (2007) Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof 30:303–321. https://doi.org/10.1177/0163278707307899

    Article  PubMed  Google Scholar 

  32. Stern MJ, Bilgen I, Dillman DA (2014) The state of survey methodology: challenges, dilemmas, and new frontiers in the era of the tailored design. Field Methods 26:284–301. https://doi.org/10.1177/1525822X13519561

    Article  Google Scholar 

  33. Attenello FJ, Buchanan IA, Wen T et al (2018) Factors associated with burnout among US neurosurgery residents: a nationwide survey. J Neurosurg 129:1349–1363. https://doi.org/10.3171/2017.9.JNS17996

    Article  PubMed  Google Scholar 

  34. O’Neill BR, Velez DA, Braxton EE et al (2008) A survey of ventriculostomy and intracranial pressure monitor placement practices. Surg Neurol 70:268–273. https://doi.org/10.1016/j.surneu.2007.05.007

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, Weill Medical College of Cornell University, 525 E. 68th St, Box 99, New York, NY, 10065, USA

    Evan D. Bander & Rohan Ramakrishna

  2. Department of Neurological Surgery, George Washington University, Washington, DC, USA

    Jonathan H. Sherman

  3. Department of Neurological Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Chetan Bettegowda

  4. Department of Neurological Surgery, University of San Francisco School of Medicine, San Francisco, CA, USA

    Manish K. Aghi

  5. Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA

    Jason Sheehan

Authors
  1. Evan D. Bander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jonathan H. Sherman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chetan Bettegowda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Manish K. Aghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jason Sheehan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rohan Ramakrishna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rohan Ramakrishna.

Ethics declarations

Conflict of interest

Chetan Bettegowda is a consultant for Depuy-Synthes. Evan D. Bander, Jonathan H. Sherman, Manish K. Aghi, Jason Sheehan, and Rohan Ramakrishna have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bander, E.D., Sherman, J.H., Bettegowda, C. et al. Beyond guidelines: analysis of current practice patterns of AANS/CNS tumor neurosurgeons. J Neurooncol 151, 361–366 (2021). https://doi.org/10.1007/s11060-020-03389-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-020-03389-9

Keywords

Search

Navigation