Asymptomatic ventriculomegaly in myelomeningocele: a matched cohort study of neuropsychological outcomes across institutions with varying shunt rates
Bibliographic record
Abstract
PURPOSE: Hydrocephalus management in myelomeningocele (MMC) patients remains controversial. While most institutions recommend surgical intervention for enlarged ventricles, recent studies suggest asymptomatic ventriculomegaly may not require treatment. This study compared cognitive outcomes in MMC patients from different institutions with different hydrocephalus intervention rates. METHODS: Participants with MMC were recruited from two sites: Site 1 (Chicago area; N = 41; selective shunting protocol) and Site 2 (Houston and Toronto; N = 342; historical approach to hydrocephalus management). The 41 Site 1 patients were matched to 41 participants from Site 2 based on age, gender, lesion level, and race. Neuropsychological testing assessed various cognitive domains. Independent samples t-tests compared outcomes between sites. RESULTS: Site 1 had significantly lower shunt rates (55% shunt rate at Site 1; 83% shunt rate at Site 2). There were no significant differences in demographics or lesion levels between sites. Site 1 participants demonstrated significantly higher scores on several cognitive measures compared to Site 2, including the Purdue Pegboard (fine motor dexterity; p = 0.042), Stanford-Binet Quantitative Reasoning (quantitative reasoning to solve mathematical problems; p = 0.030), VMI (visuomotor integration; p = 0.034), WJ Letter-Word Identification (single-word reading; p = 0.026), and WJ Calculation subtests (math calculation problem-solving; p = 0.012). CONCLUSION: Neuropsychological outcomes were either similar across cohorts from institutions with different shunt rates or favored the clinic with the lower shunting rate. These findings suggest asymptomatic ventriculomegaly may not be associated with worse functional outcomes, potentially informing guidelines for hydrocephalus intervention in the MMC population.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".