Prediction of outcome and the management of severe head injuries: the attitudes of neurosurgeons.

We gave a questionnaire to a multinational group of 59 neurosurgeons to discover their views about certain aspects of predictions of outcome after severe head injury. Although there was wide variation in the opinions expressed, a majority of clinicians agreed that estimations of prognosis are possible within 3 days of severe head injury, that these estimates influence some of their management decisions, and that computer predictions should be at least as reliable as those of an experienced clinician. The findings suggest that clinicians may be receptive to the use of computerized predictions of outcome, but also indicate that many other factors influence difficult clinical decisions.