Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV Success Score Clinical article

310 J Neurosurg: Pediatrics / Volume 6 / October 2010 The debate over ETV versus CSF shunting for the treatment of childhood hydrocephalus remains largely unresolved.1,2,4,6,7,9,11,16,18,20 Recently, we used confounder-adjustment techniques (propensity score modeling) to compare the failure rate of ETV versus shunt placement.13 We found that, once adjusted for confounders, ETV is associated with a higher initial failure rate, but, over time, the failure rate becomes lower than that associated with shunt placement. In a separate publication, we used logistic regression techniques to develop and internally validate a prediction score that would, with good accuracy, predict the 6 month success rate of ETV, taking into account the patient’s age and the etiology of their hydrocephalus.14 The end product of this was the development of the ETV Success Score (ETVSS) (Table 1)—a simple means to predict 31 315