Neuroendovascular clinical trials disruptions due to COVID-19. Potential future challenges and opportunities

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BackgroundAcademic physicians aim to provide clinical and surgical care to their patients while actively contributing to a growing body of scientific literature. The coronavirus disease 2019 (COVID-19) pandemic has resulted in procedural-based specialties across the United States witnessing a sharp decline in their clinical volume and surgical cases.ObjectiveTo assess the impact of COVID-19 on neurosurgical, stroke neurology, and neurointerventional academic productivity.MethodsThe study compared the neurosurgical, stroke neurology, and neurointerventional academic output during the pandemic lockdown with the same time period in previous years. Editors from a sample of neurosurgical, stroke neurology, and neurointerventional journals provided the total number of original manuscript submissions, broken down by months, from the year 2016 to 2020. Manuscript submission was used as a surrogate metric for academic productivity.Results8 journals were represented. The aggregated data from all eight journals as a whole showed that a combined average increase of 42.3% was observed on original submissions for 2020. As the average yearly percent increase using the 2016–2019 data for each journal exhibited a combined average increase of 11.2%, the rise in the yearly increase for 2020 in comparison was nearly fourfold. For the same journals in the same time period, the average percent of COVID-19 related publications from January to June of 2020 was 6.87%.ConclusionThere was a momentous increase in the number of original submissions for the year 2020, and its effects were uniformly experienced across all of our represented journals.

Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 59%

Trends in academic productivity in the COVID-19 era: analysis of neurosurgical, stroke neurology, and neurointerventional literature

Lee

Mohanty

Albuquerque

et al. 2020

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“…Furthermore, its use may be extended to research settings, given the widespread disruption of research during the pandemic. 9 The limitations of virtual care are largely related to the inability to physically examine a patient. However, many aspects of the neurological examination can be adapted to be virtually assessed, particularly if screen-sharing is available through the video conference platform.…”

Section: Discussionmentioning

confidence: 99%

Transition to virtual appointments for interventional neuroradiology due to the COVID-19 pandemic: a survey of satisfaction

Lun

Walker

Daham

et al. 2020

BackgroundThe COVID-19 pandemic has changed the way medicine is practiced, including the implementation of virtual care in many specialties. In the field of interventional neuroradiology (INR), virtual clinics are an uncommon practice with minimal literature to support its use. Our objective was to report prospective, single-centre data regarding patient and physician experience with virtual INR clinics for routine follow-up appointments.MethodsWe surveyed all patients that participated in a virtual INR clinic follow-up appointment at our hospital over a 3 month period. Information gathered included length of appointment delays (ie, wait times), length of appointment times, overall satisfaction, and perceived safety metrics. A survey was also sent out to all physicians who participated in virtual clinics with similar questions.Results118/122 patients and 6/6 physicians completed the survey. Wait times before previous in-person appointments were perceived to be much longer than virtual appointments, whereas in-person appointment times were longer. 112/118 (94.9%) patients and 4/6 (67%) physicians reported general satisfaction with their virtual clinic experience. There were 8/118 patients who felt their conditions could not be safely assessed virtually, compared with 1/6 (17%) physicians. Lastly, 72.2% of patients reported that they would prefer virtual or telephone visits in the future for non-urgent follow-up, and 5/6 (83%) of physicians reported the same.ConclusionVirtual INR clinics are more efficient and are preferred among patients and physicians for non-urgent follow-up appointments. Our study demonstrates the feasibility of a virtual platform for INR care, which could be sustainable for future practice.

“…Surveys designed to address highpriority issues in other medical specialties have unanimously demonstrated marked disruptions in clinical practice. [27][28][29][30] Although the present study did not specifically address the effects of COVID-19 on neurovascular research, a concomitant study has also revealed widespread disruptions in aneurysm and stroke clinical trials due to missed enrollments and protocol deviations from missed clinical or imaging follow-up 31 These broad vantage points are particularly important given the widespread fears about resurgent infection, 32 33 with the persistence of the virus in communities across the US. This data helps inform current responses, but also future ones in the event of subsequent pandemics.…”

Section: Discussionmentioning

confidence: 99%

The professional and personal impact of the coronavirus pandemic on US neurointerventional practices: a nationwide survey

Fargen

Leslie‐Mazwi

Klucznik

et al. 2020

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BackgroundLittle is currently known about the effects of the coronavirus (COVID-19) pandemic on neurointerventional (NI) procedural volumes or its toll on physician wellness.MethodsA 37-question online survey was designed and distributed to physician members of three NI physician organizations.ResultsA total of 151 individual survey responses were obtained. Reduced mechanical thrombectomy procedures compared with pre-pandemic were observed with 32% reporting a greater than 50% reduction in thrombectomy volumes. In concert with most (76%) reporting at least a 25% reduction in non-mechanical thrombectomy urgent NI procedures and a nearly unanimous (96%) cessation of non-urgent elective cases, 68% of physicians reported dramatic reductions (>50%) in overall NI procedural volume compared with pre-pandemic. Increased door-to-puncture times were reported by 79%. COVID-19-positive infections occurred in 1% of physician respondents: an additional 8% quarantined for suspected infection. Sixty-six percent of respondents reported increased career stress, 56% increased personal life/family stress, and 35% increased career burnout. Stress was significantly increased in physicians with COVID-positive family members (P<0.05).ConclusionsThis is the first study designed to understand the effects of the COVID-19 pandemic on NI physician practices, case volumes, compensation, personal/family stresses, and work-related burnout. Future studies examining these factors following the resumption of elective cases and relaxing of social distancing measures will be necessary to better understand these phenomena.