ArticleActa neurochirurgica2018
Shunt surgery in idiopathic normal pressure hydrocephalus is cost-effective-a cost utility analysis.
Article in Acta neurochirurgica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Model-Based Economic Evaluations of Interventions for Dementia: An Updated Systematic Review and Quality Assessment.Applied health economics and health policy · 2024Pooled it
- Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus.Neurologia medico-chirurgica · 2021Guideline
- Standardizing Normal Pressure Hydrocephalus Diagnosis: The Interdisciplinary Lausanne's Protocol.Neuro-degenerative diseases · 2026Article
- Economic analysis and healthcare implications of underdiagnosed idiopathic normal pressure hydrocephalus in Italy's aging population.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Idiopathic normal pressure hydrocephalus: validation of the DESH score in the Capital Region of Denmark.Acta neurochirurgica · 2026Article
- Clinical characteristics and outcomes after shunt surgery in idiopathic normal pressure hydrocephalus with or without prior cerebrospinal fluid tap testing: a single-center follow-up study of 481 patients.Fluids and barriers of the CNS · 2026Article
- MRI-Based Prediction of Clinical Improvement after Ventricular Shunt Placement for Normal Pressure Hydrocephalus: Development and Evaluation of an Integrated Multisequence Machine Learning Algorithm.AJNR. American journal of neuroradiology · 2024Article
- Profiling iNPH features through cluster analysis: an aid for clinical suspicion and diagnosis.Acta neurochirurgica · 2024Article
- Awareness level of idiopathic normal pressure hydrocephalus among health-care providers.Surgical neurology international · 2024Article
- Idiopathic Normal Pressure Hydrocephalus: The Real Social and Economic Burden of a Possibly Enormous Underdiagnosis Problem.Tomography (Ann Arbor, Mich.) · 2023Article
- Diffusion tensor imaging helps identify shunt-responsive normal pressure hydrocephalus patients among probable iNPH cohort.Neurosurgical review · 2023Article
- Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus: a population-based study.BMC geriatrics · 2023Article
- Idiopathic normal pressure hydrocephalus: postoperative patient perspective and quality of life.Acta neurochirurgica · 2022Article
- Callosal Angle Narrowing in Research Data Bases of the Cognitively Impaired.AJNR. American journal of neuroradiology · 2022Article
- Dual-Task Performance in Older Adults With and Without Idiopathic Normal Pressure Hydrocephalus.Frontiers in aging neuroscience · 2022Article
- Evaluation of the Effectiveness of the Tap Test by Combining the Use of Functional Gait Assessment and Global Rating of Change.Frontiers in neurology · 2022Article
- Lumbar and ventricular CSF concentrations of extracellular matrix proteins before and after shunt surgery in idiopathic normal pressure hydrocephalus.Fluids and barriers of the CNS · 2021Article
- CSF Dynamics for Shunt Prognostication and Revision in Normal Pressure Hydrocephalus.Journal of clinical medicine · 2021Review
- The cost-effectiveness of Cochlear implants in Swedish adults.BMC health services research · 2021Article
- Structural volumetry in NPH diagnostics and treatment-future or dead end?Neurosurgical review · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).
methodsHealth-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care. The cost of untreated patients was derived from the cost of dementia disorders in Sweden in 2012, as reported by the National Board of Health and Welfare. The cost effectiveness analysis used a decision-analytic Markov model. We used a societal perspective and a lifelong time horizon to estimate costs and effects. One-way sensitivity analysis and probabilistic sensitivity analysis were carried out to test the robustness of the model.
resultsThe shunt surgery model as the standard treatment in iNPH resulted in a gain of 2.2 life years and 1.7 quality-adjusted life years (QALY), along with an incremental cost per patient of €7,500/QALY. The sensitivity analysis showed that the results were not sensitive to changes in uncertain parameters or assumptions.
conclusionsShunt surgery in iNPH, an underdiagnosed condition severely impairing elderly patients, is not only an effective medical treatment, it is also cost-effective, adding 2.2 additional life years and 1.7 QALYs at a low cost, a remarkable gain for an individual aged around 70 years.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.