University of Oulu

Tefre, S., Lilja-Cyron, A., Arvidsson, L., Bartek, J., Corell, A., Forsse, A., Glud, A. N., Hamdeh, S. A., Hansen, F. L., Huotarinen, A., Johansson, C., Kämäräinen, O.-P., Korhonen, T., Kotkansalo, A., Mansoor, N. M., Mendoza Mireles, E. E., Miscov, R., Munthe, S., Nittby-Redebrandt, H., … Juhler, M. (2022). Endoscopic third ventriculostomy for adults with hydrocephalus: Creating a prognostic model for success: protocol for a retrospective multicentre study (Nordic etv). BMJ Open, 12(1), e055570.

Endoscopic third ventriculostomy for adults with hydrocephalus : creating a prognostic model for success: protocol for a retrospective multicentre study (Nordic ETV)

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Author: Tefre, Sondre1; Lilja-Cyron, Alexander1; Arvidsson, Lisa2;
Organizations: 1Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
2Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
3Department of Neurosurgery, Sahlgrenska University Hospital, Goteborg, Sweden
4Department of Neurosurgery, Odense University Hospital, Odense, Denmark
5Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
6Department of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden
7Department of Neurosurgery NeuroCenter, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
8Department of Neurosurgery, University Hospital of Umeå, Umeå, Sweden
9Department of Neurosurgery, Oulu University Hospital, Oulu, Finland
10Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
11Department of Neurosurgery and Brain Injury Centre, Turku University Hospital, Turku, Finland
12Department of Neurosurgery, St Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Trøndelag, Norway
13Department of Neurosurgery, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
14Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway
15Department of Neurosurgery, University Hospital of North Norway, Tromso, Norway
16Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
17Department of Neurosurgery, Lund University Hospital, Lund, Sweden
18Department of Neurosurgery in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Östergötland, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
Persistent link:
Language: English
Published: BMJ, 2022
Publish Date: 2023-01-19


Introduction: Endoscopic third ventriculostomy (ETV) is becoming an increasingly widespread treatment for hydrocephalus, but research is primarily based on paediatric populations. In 2009, Kulkarni et al created the ETV Success score to predict the outcome of ETV in children. The purpose of this study is to create a prognostic model to predict the success of ETV for adult patients with hydrocephalus. The ability to predict who will benefit from an ETV will allow better primary patient selection both for ETV and shunting. This would reduce additional second procedures due to primary treatment failure. A success score specific for adults could also be used as a communication tool to provide better information and guidance to patients.

Methods and analysis: The study will adhere to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis reporting guidelines and conducted as a retrospective chart review of all patients≥18 years of age treated with ETV at the participating centres between 1 January 2010 and 31 December 2018. Data collection is conducted locally in a standardised database. Univariate analysis will be used to identify several strong predictors to be included in a multivariate logistic regression model. The model will be validated using K-fold cross validation. Discrimination will be assessed using area under the receiver operating characteristic curve (AUROC) and calibration with calibration belt plots.

Ethics and dissemination: The study is approved by appropriate ethics or patient safety boards in all participating countries.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 12
Issue: 1
Article number: e055570
DOI: 10.1136/bmjopen-2021-055570
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Funding: As this is a retrospective chart review, limited funds are required. SoT has been partially funded by the Lundbeck Foundation (F-22218-19) and the Hjerne- og Nervekirurgisk Forskningspulje, Rigshospitalet (F23026-02, N497). No other specific funding has been received for this study.
Copyright information: © Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: