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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Randomized trials and collaborative research in epilepsy surgery: future directions.
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Randomized trials and collaborative research in epilepsy surgery: future directions.

机译：癫痫手术的随机试验和协作研究：未来方向。

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BACKGROUND: Although randomized controlled trials (RCTs) are the gold standard for evaluating therapeutic interventions, surgical RCTs are particularly challenging and few have been done in the field of epilepsy surgery. We assess the level of RCT activity in epilepsy surgery and propose feasible alternatives to develop sustainable research initiatives in this area. METHODS: We undertook a systematic review of the world literature to assess the level of RCT activity in epilepsy surgery. Previous personal experience with RCTs in epilepsy surgery and examples of successful Canadian multicentre research networks were reviewed to propose initiatives for sustainable, valid research in epilepsy surgery. RESULTS: We identified 12 RCTs in epilepsy surgery, including 692 patients, of whom 416 were involved in vagus nerve stimulation, 16 in various brain electrostimulation procedures, 180 in comparisons of different surgical techniques, and 80 in a comparison of medical versus surgical therapy. Most studies wereof short duration (median=3 months, range 3-12 months). In the area of resective surgery, only temporal lobe epilepsy has been subjected to any type of RCT comparison. All RCTs have been done within the last 13 years. There were no multicentre Canadian surgical studies. CONCLUSIONS: The adoption of RCTs in epilepsy surgery has been slow and difficult worldwide. Because of its universal health care system and its well established epilepsy surgery centres, Canada is in a strong position to create a national epilepsy surgery research initiative capable of undertaking high quality, sustainable research in epilepsy surgery.
机译：背景：尽管随机对照试验（RCT）是评估治疗干预措施的金标准，但手术RCT尤其具有挑战性，在癫痫手术领域做得很少。我们评估了癫痫手术中RCT活动的水平，并提出了可行的替代方案来发展该领域的可持续研究计划。方法：我们对世界文献进行了系统评价，以评估癫痫手术中RCT活性的水平。回顾了先前在癫痫手术中使用RCT的个人经验以及成功的加拿大多中心研究网络的实例，以提出针对癫痫手术进行可持续，有效研究的倡议。结果：我们在癫痫手术中确定了12项RCT，包括692例患者，其中迷走神经刺激涉及416例，各种脑电刺激程序涉及16例，不同手术技术的比较中有180例，药物疗法与手术疗法中有80例。大多数研究持续时间短（中位数= 3个月，范围3-12个月）。在切除手术领域，仅颞叶癫痫已经进行了任何类型的RCT比较。所有RCT均在过去13年内完成。没有加拿大多中心外科手术研究。结论：RCT在癫痫手术中的应用在世界范围内进展缓慢且困难。由于其普遍的医疗保健系统和完善的癫痫外科手术中心，加拿大处于有利的地位，可以创建一项全国性的癫痫外科手术研究计划，以开展高质量，可持续的癫痫外科手术研究。

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