OBJECTIVE: To develop a model to predict the probability of endoscopic third ventriculostomy (ETV) success in the treatment for hydrocephalus on the basis of a child's individual characteristics. STUDY DESIGN: We analyzed 618 ETVs performed consecutively on children at 12 international institutions to identify predictors of ETV success at 6 months. A multivariable logistic regression model was developed on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). RESULTS: In the training set, 305/455 ETVs (67.0%) were successful. The regression model (containing patient age, cause of hydrocephalus, and previous cerebrospinal fluid shunt) demonstrated good fit (Hosmer-Lemeshow, P = .78) and discrimination (C statistic = 0.70). In the validation set, 105/163 ETVs (64.4%) were successful and the model maintained good fit (Hosmer-Lemeshow, P = .45), discrimination (C statistic = 0.68), and calibration (calibration slope = 0.88). A simplified ETV Success Score was devised that closely approximates the predicted probability of ETV success. CONCLUSIONS: Children most likely to succeed with ETV can now be accurately identified and spared the long-term complications of CSF shunting.
OBJECTIVE: To develop a model to predict the probability of endoscopic third ventriculostomy (ETV) success in the treatment for hydrocephalus on the basis of a child's individual characteristics. STUDY DESIGN: We analyzed 618 ETVs performed consecutively on children at 12 international institutions to identify predictors of ETV success at 6 months. A multivariable logistic regression model was developed on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). RESULTS: In the training set, 305/455 ETVs (67.0%) were successful. The regression model (containing patient age, cause of hydrocephalus, and previous cerebrospinal fluid shunt) demonstrated good fit (Hosmer-Lemeshow, P = .78) and discrimination (C statistic = 0.70). In the validation set, 105/163 ETVs (64.4%) were successful and the model maintained good fit (Hosmer-Lemeshow, P = .45), discrimination (C statistic = 0.68), and calibration (calibration slope = 0.88). A simplified ETV Success Score was devised that closely approximates the predicted probability of ETV success. CONCLUSIONS:Children most likely to succeed with ETV can now be accurately identified and spared the long-term complications of CSF shunting.
Authors: Jared M Pisapia; Saurabh Sinha; Deborah M Zarnow; Mark P Johnson; Gregory G Heuer Journal: Childs Nerv Syst Date: 2017-05-16 Impact factor: 1.475
Authors: José Aloysio da Costa Val Filho; Sebastião Nataniel da Silva Gusmão; Leopoldo Mandic Ferreira Furtado; Guaracy de Macedo Machado Filho; Fernando Levi Alencar Maciel Journal: Neurosurg Rev Date: 2021-02-23 Impact factor: 3.042