Foundations for evidence-based intraoperative neurophysiological monitoring.

作者: Jeremy Howick , Bernard Allan Cohen , Peter McCulloch , Matthew Thompson , Stanley A Skinner

DOI: 10.1016/J.CLINPH.2015.05.033

关键词: MedicinePsychological interventionCost effectivenessEvidence-based medicineCohort studySystematic reviewIntraoperative neurophysiological monitoringSurgeryPhysical medicine and rehabilitationRandomized controlled trialEvidence-based practice

摘要: © 2015 International Federation of Clinical Neurophysiology. In this review, we recommend means to enhance the evidence-base for intraoperative neurophysiological monitoring (IONM). We address two preliminary issues: (1) whether IONM should be evaluated as a diagnostic test or an intervention, and (2) state evidence (as presented in systematic reviews, example). Three reasons may suggested evaluate at least some applications interventions (or part "interventional cascade"). First, practical barriers limit our ability measure accuracy. Second, results are designed correlated with during surgery. Third, improve patient outcomes when IONM-directed intervention alters course Observational is growing yet more required understand conditions under which IONM, its variety settings, can benefit patients. A multi-center observational cohort study would represent important initial compromise between pragmatic difficulties conducting controlled trials Evidence-Based Medicine (EBM) view that large scale randomized required. Such base (if justified) provide rationale trials.

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