The incidence of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by microsurgical clipping versus endovascular coiling: a systematic review
Bibliographic record
Abstract
Objective To systematically review the risk of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by microsurgical clipping versus endovascular coiling. Methods A comprehensive literature search from January 1990 to September 2015 was conducted in electronic databases, such as PubMed, EMBASE/SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI) and Wanfang data, for randomized controlled trials (RCTs) or observational studies. Key words were defined as hydrocephalus, shunt, clipping, coiling, surgical, endovascular, embolization, treatment, intracranial aneurysm, cerebral aneurysm, subarachnoid hemorrhage both in Chinese and English. Manual search was also conducted on several relevant journals, such as Chinese Journal of Neurosurgery, Chinese Journal of Contemporary Neurology and Neurosurgery, Chinese Journal of Cerebrovascular Diseases, and so on. Data were extracted and evaluated by two reviewers independently. Jadad Scale was used to assess the quality of RCTs. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of nonrandomized controlled trials. RevMan 5.3 and Stata 13.1 were used for Meta-analysis. Results Eighteen observational studies were finally included, involving 15 920 patients with ruptured intracranial aneurysms, among whom 10 038 patients underwent clipping and 5882 underwent coiling. The result of Meta-analysis indicated that there was no statistical significance on the incidence of shunt-dependent hydrocephalus between clipping and coiling (OR = 0.860, 95%CI: 0.720-1.030; P = 0.110). However, the findings showed low stability as the results of fixed effects model and random effects model were different. The result of Egger's test indicated no publication bias (P = 0.795). Conclusions The frequency of shunt-dependent hydrocephalus was not significantly different between clipping and coiling. However, the conclusion still needs to be further verified by high-quality studies. DOI: 10.3969/j.issn.1672-6731.2016.02.003
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.030 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.014 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".