Kulkarni Abhaya V, Riva-Cambrin Jay, Browd Samuel R
Division of Neurosurgery, Hospital for Sick Children, Toronto, Canada.
J Neurosurg Pediatr. 2011 Feb;7(2):143-6. doi: 10.3171/2010.11.PEDS10296.
Published case series of endoscopic third ventriculostomy (ETV) for childhood hydrocephalus have reported widely varying success rates. The authors recently developed and internally validated the ETV Success Score (ETVSS); this is a simplified means of predicting the 6-month success rate of ETV for a child with hydrocephalus, based on age, etiology of hydrocephalus, and presence of a previous shunt. The authors hypothesized that the ETVSS would be able to predict with reasonable accuracy the actual ETV success rate reported among published case series.
A literature search was performed to identify published pediatric ETV papers that contained enough information with which to calculate an aggregate, mean predicted ETVSS for the cohort. This was then compared with the actual ETV success rate in the cohort. Data were extracted independently in triplicate, including by 2 individuals who were not involved with the development of the ETVSS.
Fifteen papers reporting on 322 patients were included. Interrater reliability was very high in determining the predicted ETVSS (intraclass correlation coefficient 0.99). The predicted ETVSS for each paper agreed strongly with the actual ETV success rate reported in each paper (reliability intraclass correlation coefficient 0.81). There was no significant difference in the magnitude of the predicted ETVSS and the actual ETV success (p = 0.98, paired t-test). In a linear regression model, the predicted ETVSS explained 62% of the variation in actual ETV success. When the entire cohort was combined and analyzed together, the overall mean predicted ETVSS was 57.9%, which was nearly identical to the actual ETV success rate of 59.2%.
The ETVSS closely predicts the actual ETV success rate reported in selected papers published over the last 20 years and explains much of the variation.
已发表的关于儿童脑积水内镜下第三脑室造瘘术（ETV）的病例系列报道成功率差异很大。作者最近开发并内部验证了ETV成功评分（ETVSS）；这是一种基于年龄、脑积水病因和既往是否有分流术来预测脑积水患儿ETV 6个月成功率的简化方法。作者假设ETVSS能够合理准确地预测已发表病例系列中报道的实际ETV成功率。
进行文献检索，以确定已发表的儿科ETV论文，这些论文包含足够的信息来计算该队列的总体平均预测ETVSS。然后将其与该队列中的实际ETV成功率进行比较。数据由三人独立提取，其中包括两名未参与ETVSS开发的人员。
纳入了15篇报道322例患者的论文。在确定预测的ETVSS方面，评分者间信度非常高（组内相关系数为0.99）。每篇论文的预测ETVSS与该论文报道的实际ETV成功率高度一致（组内相关系数为0.81）。预测的ETVSS大小与实际ETV成功率之间无显著差异（p = 0.98，配对t检验）。在一个线性回归模型中，预测的ETVSS解释了实际ETV成功率变化的62%。当将整个队列合并在一起分析时，总体平均预测ETVSS为57.9%，与实际ETV成功率59.2%几乎相同。
ETVSS能密切预测过去20年发表的部分论文中报道的实际ETV成功率，并解释了大部分变异情况。
