Practice variability in vagus nerve stimulation settings for drug-resistant epilepsy and a pilot quality improvement initiative to optimize stimulation parameters

Substantial practice variability in VNS parameter settings with suboptimal utilization of therapy existed, which improved following introduction of the pilot intervention. Standardized protocols can ensure timely delivery of therapeutic parameters. These strategies have been underutilized in earlier studies, likely overestimating the time to response from VNS therapy.