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Shortfalls in pediatric hydrocephalus clinical outcome analysis
Mohammad Sami Walid1, Joe Sam Robinson
1Georgia NeuroCenter, Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31201, USA. mswalid@yahoo.com
Insights
Child hydrocephalus treatment costs have significantly increased, while patient discharges decreased. The literature shows a plateau in research, with few studies on cost analysis or high-level evidence.
Area of Science:
- Pediatric Neurosurgery
- Health Economics
- Medical Informatics
Background:
- Childhood hydrocephalus presents significant treatment challenges.
- Understanding treatment outcomes and costs is crucial for healthcare management.
- Literature analysis can reveal trends in research and clinical practice.
Purpose of the Study:
- To analyze trends in child hydrocephalus treatment costs and literature.
- To assess the volume and focus of research on pediatric hydrocephalus.
- To evaluate cost awareness in the scientific literature concerning hydrocephalus.
Main Methods:
- Utilized Nationwide Inpatient Sample (NIS) data to extract hospital charges for pediatric hydrocephalus treatment.
- Employed PubMed search engine to probe biomedical literature on child hydrocephalus.
- Analyzed trends in aggregate hospital charges, patient discharges, and publication volume over 13-15 years.
Main Results:
- Aggregate hospital charges for ventriculo-peritoneal shunting in children under 18 increased 1.7-fold to $235.6 million by 2009.
- Hospital discharges decreased by 25.5% over 13 years.
- Literature on child hydrocephalus increased 1.6-fold, but randomized controlled trials (0.94%) and cost analysis papers (0.77%) remain scarce.
Conclusions:
- Research on pediatric hydrocephalus has plateaued, with a concerning lack of high-grade clinical evidence (RCTs).
- There is a significant gap in the literature regarding cost analysis and economic considerations for hydrocephalus treatment.
- Increased focus on cost-effectiveness and robust clinical trials is needed for managing childhood hydrocephalus.
Background:
In this paper, we used search engine technology to study outcome analysis and cost awareness of child hydrocephalus in the literature.
Methods:
The aggregate hospital charges of hydrocephalus treatment procedures for patients <18 years old was extracted from the Nationwide Inpatient Sample (NIS) data. Hydrocephalus literature was probed through the PubMed biomedical search engine.
Results:
Aggregate hospital charges associated with ventriculo-peritoneal shunting as the principle procedure for patients <18 years old have increased 1.7-fold over a 13-year period to 235.6 million in 2009. Hospital discharges, however, decreased from 3,390 in 1997 to 2,525 in 2009 (25.5% decrease over 13 years). The number of papers in English language indexed by PubMed in relation to child hydrocephalus in humans increased from 81 papers in 1996 to 133 in 2010 (1.6-fold increase), totaling 1,694 over 15 years. Randomized controlled trials published in relation to child hydrocephalus totaled 16 over the same period (0.94% of child hydrocephalus papers). Papers related to child hydrocephalus with "costs and cost analysis" as medical subject heading totaled 13 papers (0.77%).
Conclusions:
Over the past 15 years, disappointingly the number of printed child hydrocephalus papers appeared to have only plateaued. Strikingly, only a very small number of these papers were directed toward randomized control studies, the sine qua non of high-grade clinical evidence. Moreover, very few papers make reference to cost analysis or economics in the treatment of hydrocephalus - an issue coming increasingly before the nation at this point.
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