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Article: Establishing a Gold Standard for Noninvasive Identification of Painful Lumbar Discs: Prospective Comparison of Magnetic Resonance Spectroscopy vs Low-Pressure Provocation Discography.

Gornet, Matthew G / Peacock, James / Ryken, Timothy / Schranck, Francine W / Eastlack, Robert K / Lotz, Jeffrey C

International journal of spine surgery

2024

Language	English
Publishing date	2024-02-27
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/8574
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Article ; Online: Congress of neurological surgeons systematic review and evidence-based clinical practice parameter guidelines for the treatment of adults with newly diagnosed glioblastoma: Introduction and Methods.

Olson, Jeffrey J / Ryken, Timothy C

Journal of neuro-oncology

2020 Volume 150, Issue 2, Page(s) 87–93

Abstract: Purpose: This is an update of the evidence-based guideline for management of newly diagnosed glioblastomas sponsored by the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) initially published in 2008. The ...

Abstract	Purpose: This is an update of the evidence-based guideline for management of newly diagnosed glioblastomas sponsored by the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) initially published in 2008. The objective is to update evidence-based management of newly diagnosed glioblastomas over all commonly used diagnostic and treatment modalities in regularly encountered clinical situations. Methods: A multidisciplinary writing group was assembled to create documents related to imaging, cytoreductive surgery, neuropathology, radiation therapy, chemotherapy and emerging developments. Questions from the prior set of guidelines, and new and modified questions were used to guide a search of the scientific literature since the last guideline search was completed in June 2005. Citations were screened, classified and used as evidence to create recommendations addressing the questions in a manner that was directly linked to this evidence. Results: The sixteen writers produced 34 questions resulting in eight Level I recommendations, eleven Level II recommendations, and 27 Level II recommendations across all the topics. In some instances, insufficient data was available to answer all or part of a question and this is stated and explained. Conclusions: This series of guidelines is based upon relevant evidence in the literature related to the management of newly diagnosed glioblastomas. They set a benchmark for the management of this disease while highlighting key areas of weakness in our knowledge and suggest directions for future basic and clinical research to improve evidence quality and recommendation strength.
MeSH term(s)	Adult ; Evidence-Based Practice/methods ; Evidence-Based Practice/standards ; Glioblastoma/diagnosis ; Glioblastoma/therapy ; Humans ; Neurosurgeons/standards ; Practice Guidelines as Topic/standards ; Systematic Reviews as Topic
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Editorial
ZDB-ID	604875-4
ISSN	1573-7373 ; 0167-594X
ISSN (online)	1573-7373
ISSN	0167-594X
DOI	10.1007/s11060-020-03593-7
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Article: Intra-operative emergence of occult dural arteriovenous fistula after middle meningeal artery embolization for chronic subdural hematoma: Case report and literature review.

Tavakkoli, Armin / Montejo, Julio D / Calnan, Daniel R / Ryken, Timothy C / Eskey, Clifford J

Radiology case reports

2022 Volume 17, Issue 5, Page(s) 1470–1474

Abstract: Dural arteriovenous fistulae of the middle meningeal artery (MMA-dAVF) are high risk lesions that can lead to intracranial hemorrhage. We describe the case of an adult male that presented with chronic subdural hematomas and was treated with burr hole ... ...

Abstract	Dural arteriovenous fistulae of the middle meningeal artery (MMA-dAVF) are high risk lesions that can lead to intracranial hemorrhage. We describe the case of an adult male that presented with chronic subdural hematomas and was treated with burr hole craniotomy plus middle meningeal artery (MMA) embolization. Although the pre-embolization angiogram showed no signs of a fistula, a fistula arising from the MMA and draining into the superior sagittal sinus emerged intra-operatively. To our knowledge, this is the first case of intra-operative emergence of occult MMA-dAVF with intracranial drainage during MMA embolization for chronic subdural hematoma treatment. This observation supports monitoring for and embolizing spontaneous MMA-dAVF following MMA embolization.
Language	English
Publishing date	2022-03-03
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2021.12.012
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Article ; Online: Examining barriers to implementing a surgical-site infection bundle.

Dukes, Kimberly C / Reisinger, Heather Schacht / Schweizer, Marin / Ward, Melissa A / Chapin, Laura / Ryken, Timothy C / Perl, Trish M / Herwaldt, Loreen A

Infection control and hospital epidemiology

2023 Volume 45, Issue 1, Page(s) 13–20

Abstract: Background: Surgical-site infections (SSIs) can be catastrophic. Bundles of evidence-based practices can reduce SSIs but can be difficult to implement and sustain.: Objective: We sought to understand the implementation of SSI prevention bundles in 6 ... ...

Abstract	Background: Surgical-site infections (SSIs) can be catastrophic. Bundles of evidence-based practices can reduce SSIs but can be difficult to implement and sustain. Objective: We sought to understand the implementation of SSI prevention bundles in 6 US hospitals. Design: Qualitative study. Methods: We conducted in-depth semistructured interviews with personnel involved in bundle implementation and conducted a thematic analysis of the transcripts. Setting: The study was conducted in 6 US hospitals: 2 academic tertiary-care hospitals, 3 academic-affiliated community hospitals, 1 unaffiliated community hospital. Participants: In total, 30 hospital personnel participated. Participants included surgeons, laboratory directors, clinical personnel, and infection preventionists. Results: Bundle complexity impeded implementation. Other barriers varied across services, even within the same hospital. Multiple strategies were needed, and successful strategies in one service did not always apply in other areas. However, early and sustained interprofessional collaboration facilitated implementation. Conclusions: The evidence-based SSI bundle is complicated and can be difficult to implement. One implementation process probably will not work for all settings. Multiple strategies were needed to overcome contextual and implementation barriers that varied by setting and implementation climate. Appropriate adaptations for specific settings and populations may improve bundle adoption, fidelity, acceptability, and sustainability.
MeSH term(s)	Humans ; Qualitative Research ; Surgical Wound Infection/prevention & control ; Personnel, Hospital ; Hospitals, Community
Language	English
Publishing date	2023-07-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.114
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Article ; Online: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Treatment of Adults With Metastatic Brain Tumors: Executive Summary.

Olson, Jeffrey J / Kalkanis, Steven N / Ryken, Timothy C

Neurosurgery

2019 Volume 84, Issue 3, Page(s) 550–552

Abstract: Background: The Congress of Neurological Surgeons systematic review and evidence-based clinical practice parameter guidelines for the treatment of adults with metastatic brain tumors was first published in 2010. Because of the time elapsed since that ... ...

Abstract	Background: The Congress of Neurological Surgeons systematic review and evidence-based clinical practice parameter guidelines for the treatment of adults with metastatic brain tumors was first published in 2010. Because of the time elapsed since that publication, an update of this set of guidelines based on literature published since is now indicated. Objective: To establish the best evidence-based management of metastatic brain tumors over all commonly used diagnostic and treatment modalities in regularly encountered clinical situations. Methods: Literature searches regarding management of metastatic brain tumors with whole brain radiation therapy, surgery, stereotactic radiosurgery, chemotherapy, prophylactic anticonvulsants, steroids, instances of multiple brain metastases, and emerging and investigational therapies were carried out to answer questions designed by consensus of a multidisciplinary writing group. Results: Recommendations were created and their strength linked to the quality of the literature data available thus creating an evidence-based guideline. Importantly, shortcomings and biases to the literature data are brought out so as to provide guidance for future investigation and improvements in the management of patients with metastatic brain tumors. Conclusion: This series of guidelines was constructed to assess the most current and clinically relevant evidence for management of metastatic brain tumors. They set a benchmark regarding the current evidence base for this management while also highlighting important key areas for future basic and clinical research, particularly on those topics for which no recommendations could be formulated.The full guideline can be found at: https://www.cns.org/guidelines-treatment-adults-metastatic-brain-tumors/chapter_1.
MeSH term(s)	Adult ; Brain Neoplasms/secondary ; Brain Neoplasms/surgery ; Congresses as Topic/standards ; Consensus ; Evidence-Based Medicine/standards ; Female ; Humans ; Male ; Neurosurgeons/standards ; Radiosurgery ; Therapies, Investigational
Language	English
Publishing date	2019-01-10
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyy540
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Patients' experiences and compliance with preoperative screening and decolonization.

Wilson, Ethan / Marra, Alexandre R / Ward, Melissa / Chapin, Laura / Boulden, Stephanie / Ryken, Timothy C / Jones, Lynne C / Herwaldt, Loreen A

American journal of infection control

2022 Volume 51, Issue 1, Page(s) 78–82

Abstract: Background: To improve adherence with pre-surgical screening for Staphylococcus aureus nasal carriage and decolonization, we need more information about patients' experiences with these protocols.: Methods: We surveyed patients undergoing orthopedic, ...

Abstract	Background: To improve adherence with pre-surgical screening for Staphylococcus aureus nasal carriage and decolonization, we need more information about patients' experiences with these protocols. Methods: We surveyed patients undergoing orthopedic, neurosurgical, or cardiac operations at Johns Hopkins Hospitals (JHH), the University of Iowa Hospitals and Clinics (UIHC) at MercyOne Northeast Iowa Neurosurgery (MONIN) to assess patients' experiences with decolonization protocols. Results: Five hundred thirty-four patients responded. Respondents at JHH were significantly more likely than those at the UIHC to report using mupirocin and were significantly more likely than those at the UIHC and MONIN to feel they received adequate information about surgical site infection (SSI) prevention and decolonization. Respondents at JHH were the least likely to not worry about SSI and they were more willing to do anything they could to prevent SSI. Few patients reported barriers to adherence and side effects of mupirocin or chlorhexidine. Conclusion: Respondents did not report either major side effects or barriers to adherence. Patients varied in their level of concern about SSI, their willingness to invest effort in preventing SSI, and their assessments of preoperative information. To improve patients' adherence, clinicians and hospitals should assess their patients' needs and desires and tailor their preoperative processes, education, and prophylaxis accordingly.
MeSH term(s)	Humans ; Mupirocin/therapeutic use ; Chlorhexidine/therapeutic use ; Staphylococcus aureus ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/prevention & control ; Staphylococcal Infections/drug therapy ; Nose ; Surgical Wound Infection/prevention & control ; Surgical Wound Infection/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Carrier State/drug therapy
Chemical Substances	Mupirocin (D0GX863OA5) ; Chlorhexidine (R4KO0DY52L) ; Anti-Bacterial Agents
Language	English
Publishing date	2022-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2022.03.013
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Article: Determining an Appropriate Outcome Measure in Neurosurgical Research: Investigating Meaningful, Valid, and Practical Metrics.

Louie, Christopher / D'Agostino, Erin N / Han, David / Ryken, Timothy C

Cureus

2019 Volume 11, Issue 9, Page(s) e5610

Abstract: Given the rapidly evolving pace of research and technology in the neurosurgical field, it is critical to consider the parameters of valid, practical, and meaningful study outcome measures. Here we review fundamental aspects of selecting outcome measures ... ...

Abstract	Given the rapidly evolving pace of research and technology in the neurosurgical field, it is critical to consider the parameters of valid, practical, and meaningful study outcome measures. Here we review fundamental aspects of selecting outcome measures in the context of neurosurgical research. Exemplifying work in meningiomas and high-grade gliomas, we delineate a proposed framework for identifying an appropriate outcome measure. Four fundamental components of an outcome measure are defined and characterized: understanding characteristics of a good outcome measure; developing a research question to address an outcome measure; defining the outcome measure, and considering limitations of an outcome measure. This four-part framework enhances and promotes the methodology for determining if an outcome measure is valid, practical, and ultimately meaningful.
Language	English
Publishing date	2019-09-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.5610
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Article ; Online: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Treatment of Adults With Vestibular Schwannomas: Executive Summary.

Olson, Jeffrey J / Kalkanis, Steven N / Ryken, Timothy C

Neurosurgery

2018 Volume 82, Issue 2, Page(s) 129–134

Abstract: Background: Vestibular schwannomas (VS) are uncommon lesions that are a substantial challenge to the neurosurgeons, otologists, and radiation oncologists who undertake their clinical management. A starting point to improving the current knowledge is to ... ...

Abstract	Background: Vestibular schwannomas (VS) are uncommon lesions that are a substantial challenge to the neurosurgeons, otologists, and radiation oncologists who undertake their clinical management. A starting point to improving the current knowledge is to define the benchmarks of the current research studying VS management using evidence-based techniques in order to allow meaningful points of departure for future scientific and clinical research. Objective: To establish the best evidence-based management of VS, including initial otologic evaluation, imaging diagnosis, use of surgical techniques, assessment of tumor pathology, and the administration of radiation therapy. Methods: Multidisciplinary writing groups were identified to design questions, literature searches, and collection and classification of relevant findings. This information was then translated to recommendations based on the strength of the available literature. Results: This guideline series yielded some level 2 recommendations and a greater number of level 3 recommendations directed at the management of VS. Importantly, in some cases, a number of well-designed questions and subsequent searches did not yield information that allowed creation of a meaningful and justifiable recommendation. Conclusion: This series of guidelines was constructed to assess the most current and clinically relevant evidence for the management of VS. They set a benchmark regarding the current evidence base for this type of tumor while also highlighting important key areas for future basic and clinical research, particularly on those topics for which no recommendations could be formulated. The full guidelines can be found at: https://www.cns.org/guidelines/guidelines-management-patients-vestibular-schwannoma.
MeSH term(s)	Adult ; Guidelines as Topic ; Humans ; Neuroma, Acoustic/therapy ; Systematic Reviews as Topic
Language	English
Publishing date	2018-02-05
Publishing country	United States
Document type	Introductory Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyx586
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Association between interhospital transfer and increased in-hospital mortality in patients with spinal epidural abscesses.

Pomponio, Maria K / Khan, Imad S / Evans, Linton T / Simmons, Nathan E / Ball, Perry A / Ryken, Timothy C / Hong, Jennifer

The spine journal : official journal of the North American Spine Society

2022 Volume 22, Issue 6, Page(s) 921–926

Abstract: Background context: Spinal epidural abscess (SEA) is an uncommon yet serious infection, associated with significant morbidity and mortality. Patients diagnosed with SEA often require surgical interventions or critical care services that are not ... ...

Abstract	Background context: Spinal epidural abscess (SEA) is an uncommon yet serious infection, associated with significant morbidity and mortality. Patients diagnosed with SEA often require surgical interventions or critical care services that are not available at community hospitals and are therefore transferred to tertiary care centers. Little is known about the effects of interhospital transfer on acute outcomes for patients with SEA. Purpose: To study the effects of interhospital transfer on acute outcomes for patients with SEA. Study design: Cross sectional analysis using the 2009 to 2017 National Inpatient Sample (NIS). Patient sample: Using the 2009 to 2017 NIS, we identified cases of SEA using ICD, Ninth, or Tenth Revision diagnosis codes 324.1 & G06.1. Outcome measures: Our primary endpoint was in hospital mortality. Methods: The association between interhospital transfer and inpatient mortality was assessed using multivariable logistic regression to adjust for potential covariates. Patient and hospital factors associated with interhospital transfer were assessed in a secondary analysis. Results: A total of 21.5% of patient with SEA were treated after transfer from another hospital. After adjusting for covariates, those who presented after transfer had higher odds of death during hospitalization (OR: 1.51, 95% CI 1.27-1.78, p<.001). Transferred patients were significantly more likely to live in rural communities (11.4 % vs. 5.3 % for nontransferred patients). Conclusions: Interhospital transfer, which occurred more frequently in patients from rural hospitals, was associated with death even after controlling for disease severity. Addressing healthcare delivery disparities across the US, including across the rural-urban spectrum, will require better understanding of the observed increased mortality of interhospital transfer as a preventable source of in-hospital mortality for SEA.
MeSH term(s)	Cross-Sectional Studies ; Epidural Abscess ; Hospital Mortality ; Hospitalization ; Humans ; Patient Transfer ; Retrospective Studies
Language	English
Publishing date	2022-01-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2022.01.007
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Zs.A 5898: Show issues

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Article ; Online: The role of neuropathology in the management of newly diagnosed glioblastoma: a systematic review and evidence-based clinical practice guideline.

Velázquez Vega, José E / Brat, Daniel J / Ryken, Timothy C / Olson, Jeffrey J

Journal of neuro-oncology

2020 Volume 150, Issue 2, Page(s) 143–164

Abstract: Target population: These recommendations apply to adult patients with newly diagnosed or suspected glioblastoma (GBM) QUESTION : For adult patients with newly diagnosed GBM does testing for Isocitrate Dehydrogenase 1 or 2 (IDH 1/2) mutations afford ... ...

Abstract	Target population: These recommendations apply to adult patients with newly diagnosed or suspected glioblastoma (GBM) QUESTION : For adult patients with newly diagnosed GBM does testing for Isocitrate Dehydrogenase 1 or 2 (IDH 1/2) mutations afford benefit beyond standard histopathology in providing accurate classification and outcome prognostication? Level III IDH 1/2 mutational status by immunohistochemistry (IHC) and/or sequencing is suggested for classification and prognostic information. Level III Non-canonical IDH 1/2 mutations are very rare in patients aged 55 or older and universal testing of variant mutations by sequence analysis is not suggested for this age range. Question: For adult patients with lower grade infiltrating astrocytomas (WHO grades II and III) can the IDH-wildtype status designation supersede histopathology to predict prognosis and biologic relevance to eventual behavior as a GBM? Level III The designation of infiltrating astrocytomas (WHO grades II and III) as IDH-wildtype is not suggested as sufficient for a higher grade designation alone. Level III It is suggested that IDH-wildtype WHO grades II and III astrocytomas be tested for molecular-genetic alterations typical of IDH-wildtype GBM such as EGFR amplification, gain of chromosome 7/loss of chromosome 10 and TERT-p mutation to substantiate prediction of behavior similar to IDH-wildtype glioblastoma. Level III It is suggested that a diagnosis of diffuse astrocytic glioma, IDH-wildtype, with molecular features of GBM, WHO grade IV be rendered for infiltrating astrocytomas that lack histologic criteria of GBM but harbors molecular-genetic alterations of IDH-wildtype glioblastoma. Question: For adult patients with newly diagnosed infiltrating glioma arising in the midline does testing for H3-K27M mutations provide information beyond that gained by histopathology for accurate classification and outcome prognostication? Level III It is suggested that infiltrating gliomas arising in midline anatomic locations be tested for the H3-K27M mutation as they tend to exhibit WHO grade IV behavior even if they lack histologic criteria for glioblastoma.
MeSH term(s)	Adult ; Biomarkers, Tumor/genetics ; Disease Management ; Evidence-Based Practice/standards ; Glioblastoma/genetics ; Glioblastoma/pathology ; Glioblastoma/therapy ; Humans ; Neuropathology/methods ; Practice Guidelines as Topic/standards
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	604875-4
ISSN	1573-7373 ; 0167-594X
ISSN (online)	1573-7373
ISSN	0167-594X
DOI	10.1007/s11060-020-03616-3
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