Evaluating Awake Craniotomies in Glioma Patients: Meeting the Challenge

  • Bart Lutters
  • Marike L. D. BroekmanEmail author


Awake craniotomies are increasingly applied during resective glioma surgery. Even though the technique has had a significant impact on patient care, several questions regarding its efficacy and risks remain to be elucidated. This poses a challenge to the neurosurgical community, as the use of large randomized trials may be infeasible. The Institute of Medicine has recently introduced the learning health system, a system that aims to facilitate continuous learning activities by tempering the traditional dividing line between clinical research and clinical care. Here, we aim to identify the various challenges associated with evaluating awake craniotomies in glioma patients and to propose the learning healthcare system and its associated ethics framework as a potential solution.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryErasmus University Medical CenterRotterdamThe Netherlands
  2. 2.Department of Pediatric NeurosurgeryBrain Center Rudolf Magnus, University Medical Center Utrecht—Princess Máxima CenterUtrechtThe Netherlands
  3. 3.Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC)Brigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  4. 4.Department of NeurosurgeryHaaglanden Medical CenterThe HagueThe Netherlands
  5. 5.Department of NeurosurgeryLeiden University Medical CenterLeidenThe Netherlands

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