title: [Variability in decision-making for treatment choice of intracranial aneurysms].
abstract: OBJECTIVE
  To measure the variability in choosing treatment options in different clinical situations involving intracranial aneurysms.
  
  
  METHODS
  A questionnaire regarding 25 clinical cases was presented via visual projection, to attendees of the Congrès de la Société française de neurochirurgie et de la Société de langue française de neurochirurgie held in Toulouse from May 9th to May 12th, 2012. The audience (n=59) consisted of 58 neurosurgeons and one neuroradiologist. A minority of them (29.2%) stated that they specialized in vascular neurosurgery. The questionnaire dealt with 25 illustrative clinical cases, in which age, gender, and clinical context were provided along with the corresponding angiographic image of the aneurysm. The questionnaire asked whether the physician would have proposed treatment, and if so, which type of treatment (clip, coil or other). In addition, the physician had to indicate, on a scale of one to ten, the degree of confidence they had in their decision.
  
  
  RESULTS
  For one-third of the cases, there was at least 10% of the respondents who opted for a decision opposite to the one of the majority. For 41.7% of the cases, the proportion of respondents who opted for the clip was not significantly different from the proportion of those who opted for the coil.
  
  
  CONCLUSIONS
  Even in a relatively homogenous group of physicians, there were significantly diverging opinions regarding the management of cerebral aneurysms. This demonstrates the need for evidence-based data from controlled randomized studies.
authors.affiliation: Département de radiologie, centre hospitalier de l'université de Montréal, Montréal Qc, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Roy
authors.affiliation: Département de radiologie, centre hospitalier de l'université de Montréal, Montréal Qc, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Raymond
authors.affiliation: Service de neurochirurgie, centre hospitalier de l'université de Montréal, H2L4M1 Montréal Qc, Canada. Electronic address: michel.bojanowski.chum@ssss.gouv.qc.ca.
authors.forename: M W
authors.initials: MW
authors.lastname: Bojanowski
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures
keywords: Anévrisme cérébral; Clip or coil; Clip ou coil; Clipping; Coiling; Endovascular treatment; Intracranial aneurysms; Surgical treatment; Traitement chirurgical; Traitement endovasculaire