Neurosurgery
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Randomized Controlled Trial
Does a Screening Trial for Spinal Cord Stimulation in Patients With Chronic Pain of Neuropathic Origin Have Clinical Utility (TRIAL-STIM)? 36-Month Results From a Randomized Controlled Trial.
Screening trials before full implantation of a spinal cord stimulation device are recommended by clinical guidelines and regulators, although there is limited evidence for their use. The TRIAL-STIM study showed that a screening trial strategy does not provide superior patient pain outcome at 6-month follow-up compared with not doing a screening trial and that it was not cost-effective. ⋯ The long-term results show no patient outcome benefit in undertaking an SCS screening trial.
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Multicenter Study
Assessment of Spinal Metastases Surgery Risk Stratification Tools in Breast Cancer by Molecular Subtype.
Breast cancer molecular features and modern therapies are not included in spine metastasis prediction algorithms. ⋯ Spine metastases risk tools were able to predict prognosis at a significantly higher degree after accounting for molecular features which guide treatment response.
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Randomized Controlled Trial
Duration of Prophylactic Levetiracetam After Surgery for Brain Tumor: A Prospective Randomized Trial.
Levetiracetam is commonly used as a prophylactic antiseizure medication in patients undergoing surgical resection of brain tumors. ⋯ The use of prophylactic levetiracetam did not result in significant neurotoxicity or depression when given for either 1 week or 6 weeks. The incidence of seizure after craniotomy for tumor resection is low regardless of duration of therapy.
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The most extensively validated prognostic models for traumatic brain injury (TBI) are the Corticoid Randomization after Significant Head Injury (CRASH) and International Mission on Prognosis and Analysis of Clinical Trials (IMPACT). Model characteristics outside of area under the curve (AUC) are rarely reported. ⋯ Our results were consistent with previous literature regarding discriminative validity (AUC = 0.77-0.81). However, accuracy and false positive rates of both the CRASH and IMPACT models were poor.