P.140 The clinical outcomes of patients with normal pressure hydrocephalus and fecal incontinence
Bibliographic record
Abstract
Background: Normal Pressure Hydrocephalus (NPH) is characterized by the clinical triad of dementia, gait disturbance, and urinary incontinence. An initial case series by Hakim and Adams highlighted that all patients exhibited this triad, with only one presenting with fecal incontinence. This study aims to examine the outcomes of individuals experiencing fecal incontinence who have undergone ventriculoperitoneal shunting (VPS). Methods: A systematic review and surgical case series was conducted, involving consecutive adults diagnosed with NPH and treated with VPS between September 2016 and September 2022. Results: In the cohort of 85 patients, the median duration of NPH symptoms was 3.2 years. Gait and balance symptoms were prevalent in all patients, while cognitive, bladder, and bowel symptoms were observed in 85.9%, 91.8%, and 23.5% of cases. No significant differences were noted in age, sex, neurologic diseases presence, or lower gastrointestinal or pelvic pathology. The prevalence of fecal incontinence pre-surgery, within less than 3 months, and 3 months post-surgery were 23.5%, 32.9%, and 17.6%. The systematic review search yielded 515 articles, and 18 included patients with fecal incontinence. Conclusions: The insights gained from the systematic review and cohort offer a comprehensive understanding of the outcomes observed in patients with NPH and fecal incontinence following VPS.
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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 | 0.003 | 0.028 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".