ArticleNeurosurgery2019
Noninvasive Thermal Evaluation of Ventriculoperitoneal Shunt Patency and Cerebrospinal Fluid Flow Using a Flow Enhancing Device.
Article in Neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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
7 citing papers in PubMed.
- Diagnostic Accuracy of Non-Invasive Thermal Evaluation of Ventriculoperitoneal Shunt Flow in Shunt Malfunction: A Prospective, Multi-Site, Operator-Blinded Study.Neurosurgery · 2020Trial
- Measuring CSF shunt flow with MRI using flow enhancement of signal intensity (FENSI).Magnetic resonance in medicine · 2024Article
- Smartphone-based thermography to determine shunt patency in patients with hydrocephalus.Acta neurologica Belgica · 2024Observational
- Multimodal Sensing Capabilities for the Detection of Shunt Failure.Sensors (Basel, Switzerland) · 2021Article
- Ventriculoperitoneal Shunt Alone Does Not Guarantee Spinal Cord Protection After Complex Aortic Aneurysm Repair.EJVES vascular forum · 2020Article
- Continuous, noninvasive wireless monitoring of flow of cerebrospinal fluid through shunts in patients with hydrocephalus.NPJ digital medicine · 2020Article
- Noninvasive thermal evaluation for shunt failure in the emergency room.Surgical neurology international · 2019Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundWhile a noninvasive flow determination would be desirable in the diagnosis of cerebrospinal fluid shunt malfunction, existing studies have not yet defined a role for thermal flow detection.
objectiveTo evaluate a revised test protocol using a micropumper designed to transiently enhance flow during thermal testing to determine whether thermal detection of flow is associated with progression to shunt revision surgery.
methodsEighty-two unique tests were performed in 71 shunts. The primary outcome, need for revision within 7 d of testing, was compared with results of micropumper-augmented thermal flow detection. Statistical analysis was based on blind interpretation of test results and raw temperature data recorded during testing.
resultsThe test was sensitive (73%) and specific (68%) in predicting need for revision, with 5.6-fold higher probability of revision when flow was not detected. Negative predictive value in our sample was 94.2%. The probability of not requiring revision increased with increasing total temperature drop. Analysis of various possible thresholds showed that the optimal temperature cutoff may be lower than suggested by the manufacturer (0.125°C vs 0.2°C).
conclusionThis is the first study to report a strong association between thermal flow evaluation and a clinical impression that a shunt is not malfunctioning. The current recommended threshold may increase the false positive rate unnecessarily, and as clinicians gain experience with the method, they may find value in examining the temperature curves themselves. Multicenter studies are suggested to further define a role for this diagnostic test.
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Registered trials
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