title: Programmable shunt valves for the treatment of hydrocephalus: a systematic review.
abstract: OBJECTIVE
  To evaluate the clinical effectiveness of programmable valves compared with non-programmable valves of hydrocephalus.
  
  
  METHODS
  In this paper, the authors report a systematic review and meta-analysis of complications and revision rate for programmable valves and non-programmable implantation. Randomized or non-randomized controlled trials of hydrocephalus treated by programmable and non-programmable valves were considered for inclusion.
  
  
  RESULTS
  Seven published reports of eligible studies involving 1702 participants meet the inclusion criteria. Compared with non-programmable, programmable valves had no significant difference in catheter-related complications [RR = 0.88, 95%CI (0.66,1.19), p = 0.10] and infection rate [RR = 1.25, 95%CI (0.92,1.69), p = 1.00]. There were significant differences in overall complications [RR = 0.80, 95%CI (0.67,0.96), p < 0.01], over-drainage or under-drainage complications [RR = 0.44, 95%CI (0.31,0.63), p < 0.01] and revision rate [RR = 0.56, 95%CI (0.45,0.69), p < 0.01] in favor of programmable valves.
  
  
  CONCLUSIONS
  Although the studies seem to demonstrate a small advantage for the programmable shunts, the probable bias and the difficulties in patient selection are too important to make a general conclusion.
authors.affiliation: Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui Province 230001, China.
authors.forename: H
authors.initials: H
authors.lastname: Xu
authors.forename: Z X
authors.initials: ZX
authors.lastname: Wang
authors.forename: F
authors.initials: F
authors.lastname: Liu
authors.forename: G W
authors.initials: GW
authors.lastname: Tan
authors.forename: H W
authors.initials: HW
authors.lastname: Zhu
authors.forename: D H
authors.initials: DH
authors.lastname: Chen
mesh_terms: D000818:Animals; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004322:Drainage / Q000379:methods; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control / Q000601:surgery*; D012306:Risk; D016896:Treatment Outcome
keywords: Meta-analysis; Non-programmable valves; Programmable valves; Systematic review; Ventriculal peritoneum shunt