Table 3.

Examples of stepped wedge cluster randomized trials related to neurosurgery.

Publication	Description	Reasons for SW-CRT	Relevance
Palmay et al.66	Rolling out an intensive care unit (ICU) audit-and-feedback program to 6 non-ICU services, and evaluating targeted antimicrobial utilization. Location: Toronto, Canada.	1. All participating clusters receive the intervention during the study. 2. Overcomes the financial or workload difficulties in concurrent roll-out.	One of the inpatient services receiving intervention is a neurosurgery unit.
Haugen et al.67	Rolling out the WHO Surgical Safety Checklist intervention to 5 surgical specialties (clusters), and evaluating outcomes including morbidity, mortality and length of hospital stay. Location: Norway	1. Unethical not to deliver or retract intervention with perceived benefit. 2. Logistical and financial reasons to stagger the intervention delivery	One of the surgical specialties is neurosurgery.
Schwarze et al.68	Rolling out the question prompt list intervention to 40 surgeons and assessing its effectiveness on patient engagement and well-being among patients considering major surgery. Location: United States.	1. Allows all surgeons to have access to the intervention during the study, and avoided contamination between study participants.	The participating surgeons include neurosurgeons performing high-risk neurosurgical operations.
Malone et al.69	Assessing the impact of two de-implementation strategies, order set change and facilitation training, across 9 Children’s Hospitals. Location: United States	1. Allows for phased implementation of intervention with logistical convenience. 2. Permits all clusters to receive intervention and therefore increases participation.	The intervention aims to reduce unnecessary post-operative antibiotics in surgical procedures performed by surgeons, including neurosurgeons.