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Published on: October 14, 2022
Prospective multicenter studies in pediatric hydrocephalus
John R W Kestle1, Jay Riva-Cambrin2
11Department of Neurosurgery, Division of Pediatric Neurosurgery, Primary Children's Hospital, University of Utah, Salt Lake City, Utah; and.
Insights
Prospective multicenter studies in pediatric hydrocephalus are rare but crucial. Future research should focus on specific patient groups and patient-centered outcomes like neurodevelopment to improve care.
Area of Science:
- Pediatric Neurosurgery
- Clinical Research Methodology
Background:
- Prospective multicenter clinical research in pediatric hydrocephalus is infrequent.
- Studies address diverse topics including hemorrhage management, shunt interventions, endoscopic treatments, and infection control.
Purpose of the Study:
- To review prospective multicenter studies in pediatric hydrocephalus published since 1990.
- To identify trends in research methodologies and outcome measures.
- To suggest improvements for future study designs.
Main Methods:
- Review of prospective multicenter clinical research studies.
- Analysis of study topics, methodologies (randomized trials, cohort studies, registries), and outcomes.
- Synthesis of findings from studies published since 1990.
Main Results:
- Studies have covered a wide range of hydrocephalus topics and often used device/procedure failure as primary outcomes.
- Existing studies may not capture treatment effects in specific pediatric hydrocephalus subgroups.
- Growing multicenter networks offer potential for larger patient numbers and focused studies.
Conclusions:
- Future pediatric hydrocephalus studies should incorporate focused entry criteria based on prognostic factors.
- Emphasis on patient-centered outcomes, such as neurodevelopmental assessment and quality of life, is recommended.
- Well-designed multicenter studies are vital for advancing pediatric hydrocephalus care.
Abstract:
Prospective multicenter clinical research studies in pediatric hydrocephalus are relatively rare. They cover a broad spectrum of hydrocephalus topics, including management of intraventricular hemorrhage in premature infants, shunt techniques and equipment, shunt outcomes, endoscopic treatment of hydrocephalus, and prevention and treatment of infection. The research methodologies include randomized trials, cohort studies, and registry-based studies. This review describes prospective multicenter studies in pediatric hydrocephalus since 1990. Many studies have included all forms of hydrocephalus and used device or procedure failure as the primary outcome. Although such studies have yielded useful findings, they might miss important treatment effects in specific subgroups. As multicenter study networks grow, larger patient numbers will allow studies with more focused entry criteria based on known and evolving prognostic factors. In addition, increased use of patient-centered outcomes such as neurodevelopmental assessment and quality of life should be measured and emphasized in study results. Well-planned multicenter clinical studies can significantly affect the care of children with hydrocephalus and will continue to have an important role in improving care for these children and their families.
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