title: Shortfalls in pediatric hydrocephalus clinical outcome analysis.
abstract: BACKGROUND
  In this paper, we used search engine technology to study outcome analysis and cost awareness of child hydrocephalus in the literature.
  
  
  METHODS
  The aggregate hospital charges of hydrocephalus treatment procedures for patients <18 years old was extracted from the Nationwide Inpatient Sample (NIS) data. Hydrocephalus literature was probed through the PubMed biomedical search engine.
  
  
  RESULTS
  Aggregate hospital charges associated with ventriculo-peritoneal shunting as the principle procedure for patients <18 years old have increased 1.7-fold over a 13-year period to 235.6 million in 2009. Hospital discharges, however, decreased from 3,390 in 1997 to 2,525 in 2009 (25.5% decrease over 13 years). The number of papers in English language indexed by PubMed in relation to child hydrocephalus in humans increased from 81 papers in 1996 to 133 in 2010 (1.6-fold increase), totaling 1,694 over 15 years. Randomized controlled trials published in relation to child hydrocephalus totaled 16 over the same period (0.94% of child hydrocephalus papers). Papers related to child hydrocephalus with "costs and cost analysis" as medical subject heading totaled 13 papers (0.77%).
  
  
  CONCLUSIONS
  Over the past 15 years, disappointingly the number of printed child hydrocephalus papers appeared to have only plateaued. Strikingly, only a very small number of these papers were directed toward randomized control studies, the sine qua non of high-grade clinical evidence. Moreover, very few papers make reference to cost analysis or economics in the treatment of hydrocephalus - an issue coming increasingly before the nation at this point.
authors.affiliation: Georgia NeuroCenter, Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31201, USA. mswalid@yahoo.com
authors.forename: Mohammad Sami
authors.initials: MS
authors.lastname: Walid
authors.forename: Joe Sam
authors.initials: JS
authors.lastname: Robinson
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D006849:Hydrocephalus / Q000191:economics* / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D010372:Pediatrics / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D014481:United States; D017287:Ventriculoperitoneal Shunt / Q000191:economics*