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Hydrocephalus surveillance following CSF diversion: a modified Delphi study.

Publication ,  Journal Article
Hersh, DS; Martin, JE; Bristol, RE; Browd, SR; Grant, G; Gupta, N; Hankinson, TC; Jackson, EM; Kestle, JRW; Krieger, MD; Kulkarni, AV ...
Published in: J Neurosurg Pediatr
August 1, 2022

OBJECTIVE: Long-term follow-up is often recommended for patients with hydrocephalus, but the frequency of clinical follow-up, timing and modality of imaging, and duration of surveillance have not been clearly defined. Here, the authors used the modified Delphi method to identify areas of consensus regarding the modality, frequency, and duration of hydrocephalus surveillance following surgical treatment. METHODS: Pediatric neurosurgeons serving as institutional liaisons to the Hydrocephalus Clinical Research Network (HCRN), or its implementation/quality improvement arm (HCRNq), were invited to participate in this modified Delphi study. Thirty-seven consensus statements were generated and distributed via an anonymous electronic survey, with responses structured as a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). A subsequent, virtual meeting offered the opportunity for open discussion and modification of the statements in an effort to reach consensus (defined as ≥ 80% agreement or disagreement). RESULTS: Nineteen pediatric neurosurgeons participated in the first round, after which 15 statements reached consensus. During the second round, 14 participants met virtually for review and discussion. Some statements were modified and 2 statements were combined, resulting in a total of 36 statements. At the conclusion of the session, consensus was achieved for 17 statements regarding the following: 1) the role of standardization; 2) preferred imaging modalities; 3) postoperative follow-up after shunt surgery (subdivided into immediate postoperative imaging, delayed postoperative imaging, routine clinical surveillance, and routine radiological surveillance); and 4) postoperative follow-up after an endoscopic third ventriculostomy. Consensus could not be achieved for 19 statements. CONCLUSIONS: Using the modified Delphi method, 17 consensus statements were developed with respect to both clinical and radiological follow-up after a shunt or endoscopic third ventriculostomy. The frequency, modality, and duration of surveillance were addressed, highlighting areas in which no clear data exist to guide clinical practice. Although further studies are needed to evaluate the clinical utility and cost-effectiveness of hydrocephalus surveillance, the current study provides a framework to guide future efforts to develop standardized clinical protocols for the postoperative surveillance of patients with hydrocephalus. Ultimately, the standardization of hydrocephalus surveillance has the potential to improve patient care as well as optimize the use of healthcare resources.

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Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

August 1, 2022

Volume

30

Issue

2

Start / End Page

177 / 187

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
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Hersh, D. S., Martin, J. E., Bristol, R. E., Browd, S. R., Grant, G., Gupta, N., … Wellons, J. C. (2022). Hydrocephalus surveillance following CSF diversion: a modified Delphi study. J Neurosurg Pediatr, 30(2), 177–187. https://doi.org/10.3171/2022.5.PEDS22116
Hersh, David S., Jonathan E. Martin, Ruth E. Bristol, Samuel R. Browd, Gerald Grant, Nalin Gupta, Todd C. Hankinson, et al. “Hydrocephalus surveillance following CSF diversion: a modified Delphi study.J Neurosurg Pediatr 30, no. 2 (August 1, 2022): 177–87. https://doi.org/10.3171/2022.5.PEDS22116.
Hersh DS, Martin JE, Bristol RE, Browd SR, Grant G, Gupta N, et al. Hydrocephalus surveillance following CSF diversion: a modified Delphi study. J Neurosurg Pediatr. 2022 Aug 1;30(2):177–87.
Hersh, David S., et al. “Hydrocephalus surveillance following CSF diversion: a modified Delphi study.J Neurosurg Pediatr, vol. 30, no. 2, Aug. 2022, pp. 177–87. Pubmed, doi:10.3171/2022.5.PEDS22116.
Hersh DS, Martin JE, Bristol RE, Browd SR, Grant G, Gupta N, Hankinson TC, Jackson EM, Kestle JRW, Krieger MD, Kulkarni AV, Madura CJ, Pindrik J, Pollack IF, Raskin JS, Riva-Cambrin J, Rozzelle CJ, Smith JL, Wellons JC. Hydrocephalus surveillance following CSF diversion: a modified Delphi study. J Neurosurg Pediatr. 2022 Aug 1;30(2):177–187.

Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

August 1, 2022

Volume

30

Issue

2

Start / End Page

177 / 187

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine