A mixed-methods assessment of the feasibility of conducting neurosurgical clinical research in Uganda

Authors

Zoey Petitt, Duke University, United States
Yesel Trillo Ordonez, Duke University, United States
Yuveer Kelkar, Duke University, United States
Muhammad Shakir, Aga Khan UniversityFollow
Maura Ott, Duke University, United States
Yash Patel, Duke University, United States
Chibueze Agwu, The University of Chicago Medical Center, United States
Adham M. Khalafallah, University of Miami, United States
Alexandria Mullikin, Duke University School of Medicine, United States
Alan Tang, Duke University, United States

Document Type

Article

Department

Neurosurgery

Abstract

Background: Clinical research is necessary to evaluate neurosurgical interventions, yet clinical trials are conducted less frequently in low- and middle-income countries. Because specific barriers, facilitating factors, and strategies for neurosurgical clinical research in Uganda have not been previously identified, this study evaluated neurosurgical providers' perspectives on clinical research and documentation patterns of neurosurgical variables at [BLINDED FOR REVIEW, INSTITUTION A].
Methods: Retrospective review of 166 neurosurgical patient charts assessed the frequency of documentation of key variables. Twenty-two providers working in neurosurgery participated in 6 focus group discussions (FGDs) with qualitative analysis utilizing the framework method.
Results: Chart review showed that primary diagnosis (99.4%), pupil light response (97.6%), and CT scan results (93.3%) were documented for most patients. Cranial nerve exam (61.5%), pupil size (69.9%), and time to neurosurgical intervention (45%) were documented less frequently. On average, Glasgow Coma Scale was documented for 86.6% of days hospitalized, while vital signs were documented for 12.3%. In most FGDs, participants identified follow-up, financing, recruitment, time, approval, and sociocultural factors as research barriers. Participants described how the current health workforce facilitates successful research. To improve research capacity, suggested strategies focused on research networks, data collection, leadership, participant recruitment, infrastructure, and implementation.
Conclusion: At [BLINDED FOR REVIEW, INSTITUTION A ABBREVIATION], there was variability in the frequency of documentation of neurosurgical variables, which may impact data collection for future studies. While multiple barriers were identified, sociocultural, financing, and time barriers greatly impacted neurosurgical clinical research. Despite that, identified facilitating factors and strategies could be utilized to support neurosurgical research capacity growth.

Comments

Volume, issue and pagination is not provided by the author/publisher.

Publication (Name of Journal)

World Neurosurgery

DOI

https://doi.org/10.1016/j.wneu.2023.11.079

Recommended Citation

Petitt, Z., Ordonez, Y. T., Kelkar, Y., Shakir, M., Ott, M., Patel, Y., Agwu, C., Khalafallah, A. M., Mullikin, A., Tang, A. (2023). A mixed-methods assessment of the feasibility of conducting neurosurgical clinical research in Uganda. World Neurosurgery.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/360