Research

Publications & Media

Selected peer-reviewed publications, journal covers, presentations, and press across neurotrauma outcomes, spine surgery outcomes, socioeconomic research, and patient health literacy.

Research concentrations as the principal investigator or primary author have been dedicated to four main areas: neurotrauma outcomes after severe traumatic brain injury and acute spinal cord injury, spine surgery outcomes, socioeconomic research, and patient education. The investigations below have supported the unmet need to identify biomarkers that better predict prognosis after neurotrauma and tailor interventions to augment neurological recovery.

Complete publications list on Google Scholar →

Select Publications

Neurotrauma Outcomes

Concentrations as principal investigator or primary author have been dedicated to neurotrauma outcomes after severe traumatic brain injury and acute spinal cord injury. Prior support has been directed at studies improving outcomes and at the development of neurotrauma biomarkers.

  1. Agarwal N, Aabedi AA, Torres-Espin A, et al. Decision Tree-based Machine Learning Analysis of Intraoperative Vasopressor Use to Optimize Neurological Improvement in Acute Spinal Cord Injury. Neurosurgical Focus 52(4):E9, April 2022.
  2. Deng H, Goldschmidt E, Nwachuku E, et al. Hydrocephalus and Cerebrospinal Fluid Analysis Following Severe Traumatic Brain Injury: Evaluation of a Prospective Cohort. Neurology International 13(4):527–534, October 2021.
  3. Jorge A, White MD, Agarwal N. Outcomes in Socioeconomically Disadvantaged Patients with Spinal Cord Injury: A Systematic Review. Journal of Neurosurgery: Spine 29(6):680–686, December 2018.
  4. Agarwal N, Hansberry DR, Singh PL, Heary RF, Goldstein IM. Quality Assessment of Spinal Cord Injury Patient Education Resources. Spine 39(11):E701–E704, May 2014.

Spine Surgery Outcomes

Improving outcomes following spine surgery is a parallel focus, blending clinical practice with research. As principal investigator on these studies, the work has critically analyzed perioperative surgical and patient risk factors with recognition by national academic specialty organizations.

  1. Agarwal N, White MD, Zhang X, et al. Impact of Endplate-Implant Area Mismatch on Rates and Grades of Subsidence Following Stand-alone Lateral Lumbar Interbody Fusion: An Analysis of 623 Levels. Journal of Neurosurgery: Spine 33(1):12–16, March 2020.
  2. Agarwal N, Angriman F, Goldschmidt E, et al. Relationship between Body Mass Index and Sagittal Vertical Axis Change as well as Health-Related Quality of Life in 564 Patients following Deformity Surgery. Journal of Neurosurgery: Spine, August 2019.
  3. Agarwal N, Faramand AM, Alan N, et al. Lateral Lumbar Interbody Fusion in the Elderly: A 10 Year Experience. Journal of Neurosurgery: Spine 29(5):525–529, November 2018.
  4. Agarwal N, Agarwal P, Querry A, et al. Implementation of an Infection Prevention Bundle and Increased Physician Awareness Improves Surgical Outcomes and Reduces Costs Associated with Spine Surgery. Journal of Neurosurgery: Spine 29(1):108–114, July 2018.

Socioeconomic & Policy Research

A subset of research interests examines socioeconomic policies that impact neurosurgical practice and the delivery of quality care, stemming from involvement in organized neurosurgery societies whose mission statements center on these issues.

  1. Agarwal N, Agarwal P, Taylor TM, et al. Contributions to the United States Neurosurgery Political Action Committee (NeurosurgeryPAC): A Historical Perspective. World Neurosurgery 135:273–279, March 2020.
  2. Agarwal N, White MD, Pannullo SC, Chambless LB. Analysis of National Trends in Neurosurgical Resident Attrition. Journal of Neurosurgery 131(5):1668–1673, November 2019.
  3. Agarwal N, Kashkoush A, Baucom ET, Ratliff JK, Stroink AR. Quality Reporting in Neurological Surgery: Practice Adherence to Quality Payment Program Guidelines. Neurosurgery 84(2):537–543, February 2019.
  4. Agarwal N, Gupta R, Agarwal P, et al. Descriptive Analysis of State and Federal Spine Surgery Malpractice Litigation in the United States. Spine 43(14):984–990, July 2018.

Patient Education & Health Literacy

Early investigations addressed deficiencies of patient education materials for neurosurgical patients. As principal investigator or senior author, this work culminated in a foundation award to further improve patient education and engagement through multimedia.

  1. Agarwal N, Funahashi R, Taylor T, et al. Patient Education and Engagement Through Multimedia: Prospective Pilot Study on Health Literacy in Patients with Cerebral Aneurysms. World Neurosurgery 138:e819–e826, June 2020.
  2. White MD, Latour K, Giordano M, Taylor T, Agarwal N. The Reliability and Quality of Online Patient Education Videos for Lateral Lumbar Interbody Fusion. Journal of Neurosurgery: Spine, June 2020.
  3. Agarwal N, Feghhi DP, Gupta R, et al. A Comparative Analysis of Minimally Invasive and Open Spine Surgery Patient Education Resources. Journal of Neurosurgery: Spine 21(3):468–474, September 2014.
  4. Agarwal N, Hansberry DR, Sabourin V, Tomei KL, Prestigiacomo CJ. A Comparative Analysis of the Quality of Patient Education Materials from Medical Specialties. JAMA: Internal Medicine 173(13):1257–1259, July 2013.

Journal Covers

Cover articles in The Journal of Neurosurgery Publishing Group titles.

Presentations

Talks, podcasts, webinars, and press appearances.

Video Talks

Podcast Appearances

Webinar Presentations

Press & Articles

Assessment of Patient Comprehension to Improve Health Outcomes

Informed consent is a critical part of patient care, but patients often do not understand the health care information presented to them. Patients frequently turn to the internet for professional medical websites, yet the readability of patient education resources often exceeds the reading ability of the average American adult. This disconnect can negatively impact patient understanding, leading to poor health outcomes and unnecessary hospital readmission.

This project was designed to improve the readability and accessibility of patient education materials so patients can participate in shared decision making with a better understanding of disease processes and necessary treatments. Patient education materials were analyzed and patients were assessed for their level of understanding of literature regarding their diagnosis, treatment, and prognosis. Patients are followed at scheduled clinical visits over a three-year period and reassessed for understanding and outcomes. The work has been published in high-impact journals including JAMA Internal Medicine and the Journal of Neurosurgery: Spine, and featured by Reuters Health.

Findings were also published in Dr. Agarwal's 2016 book — co-authored with David R. Hansberry, MD, PhD, and Arpan Vaikunth — The Evolution of Health Literacy: Empowering Patients through Improved Education.