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Related Concept Videos

Sensitivity, Specificity, and Predicted Value01:13

Sensitivity, Specificity, and Predicted Value

In healthcare diagnostics, laboratory tests play a crucial role in identifying and diagnosing a wide range of medical conditions. However, interpreting test results is not always straightforward. An abnormal test result does not always confirm the presence of a disease, just as a normal result does not guarantee its absence. To assess the reliability of these diagnostic tools, healthcare practitioners rely on two key statistical indicators: sensitivity and specificity.
Sensitivity is the...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...

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Related Experiment Video

Updated: Jul 15, 2026

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images
14:08

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images

Published on: April 13, 2013

Screening tests for normal-pressure hydrocephalus: sensitivity, specificity, and cost.

Mark G Burnett1, Seema S Sonnad, Sherman C Stein

  • 1Department of Neurosurgery and Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

Journal of Neurosurgery
|April 5, 2007
PubMed
Summary

Current diagnostic tests for normal-pressure hydrocephalus (NPH) lack the necessary accuracy to improve patient outcomes compared to automatic shunt insertion. Even advanced tests need to be cost-effective against prolonged lumbar drainage.

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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Published on: January 11, 2020

Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Decision Making

Background:

  • Normal-pressure hydrocephalus (NPH) diagnosis often involves tests to select patients for shunt insertion.
  • The efficacy of these tests in improving outcomes versus automatic shunt placement remains uncertain.

Purpose of the Study:

  • To evaluate the diagnostic accuracy required for screening tests to enhance outcomes in suspected NPH.
  • To assess the cost-effectiveness of current and theoretical screening tests for NPH.

Main Methods:

  • A decision analysis model was adapted to incorporate screening test performance (sensitivity and specificity).
  • The model evaluated the impact of various tests on the expected outcome for a typical 65-year-old patient with moderate dementia.
  • Cost-effectiveness analysis was performed for a hypothetical superior screening test.

Main Results:

  • No currently reported screening tests demonstrate sufficient sensitivity and specificity to improve outcomes over automatic shunt placement in NPH.
  • External lumbar drainage approaches adequate performance but is not superior.

Conclusions:

  • Existing NPH screening tests do not reliably improve patient outcomes compared to immediate shunt insertion.
  • Future diagnostic tests must offer significant cost advantages over prolonged lumbar drainage to be clinically and economically viable.