State of Accredited Endovascular Neurosurgery Training in India in 2021: Challenges to Capacity Building in Subspecialty Neurosurgical Care

Chaganty, Saisunder Shashank; Ozair, Ahmad; Rahman, Faique

doi:10.3389/fsurg.2021.705246

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…[75][76][77] In LMIC, they are defined to a lesser extent and training positions are limited in number. 78 Although having an MT operator may be superior to no care, it is extremely important that an operator is competently trained. Standardized training endorsed by governing organizations, and maintenance of certification along with competency-based evaluation, needs to be ensured.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study

et al. 2023

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Background: Despite the well-established potent benefit of mechanical thrombectomy (MT) for large vessel occlusion (LVO) stroke, access to MT has not been studied globally. We conducted a worldwide survey of countries on 6 continents to define MT access (MTA), the disparities in MTA, and its determinants on a global scale. Methods: Our survey was conducted in 75 countries through the Mission Thrombectomy 2020+ global network between November 22, 2020, and February 28, 2021. The primary end points were the current annual MTA, MT operator availability, and MT center availability. MTA was defined as the estimated proportion of patients with LVO receiving MT in a given region annually. The availability metrics were defined as ([current MT operators×50/current annual number of estimated thrombectomy-eligible LVOs]×100 = MT operator availability) and ([current MT centers×150/current annual number of estimated thrombectomy-eligible LVOs]×100= MT center availability). The metrics used optimal MT volume per operator as 50 and an optimal MT volume per center as 150. Multivariable-adjusted generalized linear models were used to evaluate factors associated with MTA. Results: We received 887 responses from 67 countries. The median global MTA was 2.79% (interquartile range, 0.70–11.74). MTA was <1.0% for 18 (27%) countries and 0 for 7 (10%) countries. There was a 460-fold disparity between the highest and lowest nonzero MTA regions and low-income countries had 88% lower MTA compared with high-income countries. The global MT operator availability was 16.5% of optimal and the MT center availability was 20.8% of optimal. On multivariable regression, country income level (low or lower–middle versus high: odds ratio, 0.08 [95% CI, 0.04–0.12]), MT operator availability (odds ratio, 3.35 [95% CI, 2.07–5.42]), MT center availability (odds ratio, 2.86 [95% CI, 1.84–4.48]), and presence of prehospital acute stroke bypass protocol (odds ratio, 4.00 [95% CI, 1.70–9.42]) were significantly associated with increased odds of MTA. Conclusions: Access to MT on a global level is extremely low, with enormous disparities between countries by income level. The significant determinants of MT access are the country’s per capita gross national income, prehospital LVO triage policy, and MT operator and center availability.

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Section: Discussionmentioning

confidence: 99%

Mechanical Thrombectomy Global Access For Stroke (MT-GLASS): A Mission Thrombectomy (MT-2020 Plus) Study

et al. 2023

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“…[ 1 , 9 , 17 ] In some instances, patients seek medical tourism or face potential mismanagement by inadequately trained neurosurgeons. [ 4 ]…”

Section: Neurosurgical Demands In Iraqmentioning

confidence: 99%

“…[1,9,17] In some instances, patients seek medical tourism or face potential mismanagement by inadequately trained neurosurgeons. [4] the more prosperous and stable Kurdistan region of Iraq and their methodologies lacked objective assessment tools. ey often focused on cases that required a single intervention to achieve desired outcomes, an approach that is seldom feasible in the complex field of neurosurgery.…”

Section: Neurosurgical Demands In Iraqmentioning

confidence: 99%