• Patricia Walicke, Aviva Abosch, Anthony Asher, Fred G Barker, Zoher Ghogawala, Robert Harbaugh, Lara Jehi, John Kestle, Walter Koroshetz, Roderick Little, Donald Rubin, Alex Valadka, Stephen Wisniewski, E Antonio Chiocca, and Workshop Participants.
• National Institute Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
• Neurosurgery. 2017 Apr 1; 80 (4): 505-514.

AbstractThis workshop addressed challenges of clinical research in neurosurgery. Randomized controlled clinical trials (RCTs) have high internal validity, but often insufficiently generalize to real-world practice. Observational studies are inclusive but often lack sufficient rigor. The workshop considered possible solutions, such as (1) statistical methods for demonstrating causality using observational data; (2) characteristics required of a registry supporting effectiveness research; (3) trial designs combining advantages of observational studies and RCTs; and (4) equipoise, an identified challenge for RCTs. In the future, advances in information technology potentially could lead to creation of a massive database where clinical data from all neurosurgeons are integrated and analyzed, ending the separation of clinical research and practice and leading to a new "science of practice."Copyright © 2017 by the Congress of Neurological Surgeons.

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