Hierarchy of Scientific Evidence and Thematic Analysis of African Neurosurgery Research – a Scoping Review

Abstract

<title>Abstract</title> <bold>Background</bold>African neurosurgical practice is faced with numerous challenges. Although there have been improvements in recent years, some problems persist. Research can help identify these problems and propose solutions for the growth of African neurosurgery. In this study, we decided to evaluate the landscape of African research.<bold>Methods</bold>PubMed, Embase, and Web of Science were searched from inception to April 24, 2020. Duplicate articles were excluded, and at least two authors reviewed non-duplicate articles on Rayyan. After data had been extracted, they were analyzed to generate descriptive statistics (number of articles and articles per local neurosurgeon). The Kruskal Wallis test and Spearman's correlation were used for bivariate data analyses.<bold>Results</bold>The authors reviewed 667 articles on neurosurgery in 34 (63%, n=54) African countries. Malawi (4.50), South Africa (3.33), and Benin (2.33) had the highest number of articles per local neurosurgeon (after excluding articles by foreign researchers). Foreign researchers published 1.0 (IQR=2.5) articles per country. Articles were published in World Neurosurgery (120, 18.0%), South African Medical Journal (44, 6.6%), and Journal of Neurosurgery Pediatrics (34, 5.1%). The articles were on pediatric neurosurgery (167, 25.0%) and neurotrauma (129, 19.3%). Also, the majority (411, 61.6%) of studies were cross-sectional.<bold>Conclusion</bold>African neurosurgeons produce a median of 0.4 articles and publish in well-established journals. Collaboration with foreign researchers significantly increases local research output. In the future, we should assess the impact of this research.

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