title: Neurologists' knowledge of and attitudes toward epilepsy surgery: a national survey.
abstract: OBJECTIVE
  In the current study, we aim to assess potential neurologist-related barriers to epilepsy surgery among Canadian neurologists.
  
  
  METHODS
  A 29-item, pilot-tested questionnaire was mailed to all neurologists registered to practice in Canada. Survey items included the following: (1) type of medical practice, (2) perceptions of surgical risks and benefits, (3) knowledge of existing practice guidelines, and (4) barriers to surgery for patients with epilepsy. Neurologists who did not complete the questionnaire after the initial mailing were contacted a second time by e-mail, fax, or telephone. After this reminder, the survey was mailed a second time to any remaining nonresponders.
  
  
  RESULTS
  In total, 425 of 796 neurologists returned the questionnaire (response rate 53.5%). Respondents included 327 neurologists who followed patients with epilepsy in their practice. More than half (56.6%) of neurologists required patients to be drug-resistant and to have at least one seizure per year before considering surgery, and nearly half (48.6%) failed to correctly define drug-resistant epilepsy. More than 75% of neurologists identified inadequate health care resources as the greatest barrier to surgery for patients with epilepsy.
  
  
  CONCLUSIONS
  A substantial proportion of Canadian neurologists are unaware of recommended standards of practice for epilepsy surgery. Access also appears to be a significant barrier to epilepsy surgery and surgical evaluation. As a result, we are concerned that patients with epilepsy are receiving inadequate care. A greater emphasis must be placed on knowledge dissemination and ensuring that the infrastructure and personnel are in place to allow patients to have timely access to this evidence-based treatment.
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Jodie I
authors.initials: JI
authors.lastname: Roberts
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Chantelle
authors.initials: C
authors.lastname: Hrazdil
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Khara
authors.initials: K
authors.lastname: Sauro
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Vautour
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Wiebe
authors.affiliation: From the Department of Clinical Neurosciences and Hotchkiss Brain Institute (J.I.R., C.H., S.W., K.S., M.V., N.W., N.J.), and Department of Community Health Sciences and O'Brien Institute for Public Health (J.I.R., S.W., K.S., N.J.), University of Calgary; and Department of Medicine (C.H.), Division of Neurology, University of British Columbia, Vancouver, Canada. nathalie.jette@albertahealthservices.ca.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jetté
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009462:Neurology; D019635:Neurosurgical Procedures / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires