Are Shunt Revisions Associated with IQ in Congenital Hydrocephalus? A Meta -Analysis.
Although it is generally acknowledged that shunt revisions are associated with reductions in cognitive functions in individuals with congenital hydrocephalus, the literature yields mixed results and is inconclusive. The current study used meta-analytic methods to empirically synthesize studies addressing the association of shunt revisions and IQ in individuals with congenital hydrocephalus. Six studies and three in-house datasets yielded 11 independent samples for meta-analysis. Groups representing lower and higher numbers of shunt revisions were coded to generate effect sizes for differences in IQ scores. Mean effect size across studies was statistically significant, but small (Hedges' g = 0.25, p < 0.001, 95 % CI [0.08, 0.43]) with more shunt revisions associated with lower IQ scores. Results show an association of lower IQ and more shunt revisions of about 3 IQ points, a small effect, but within the error of measurement associated with IQ tests. Although clinical significance of this effect is not clear, results suggest that repeated shunt revisions because of shunt failure is associated with a reduction in cognitive functions.
Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, 4849 Calhoun Rd Rm 373, Houston, TX, 77204-6022, USA. Nikki.Arrington@times.uh.edu.
C Nikki
0000-0001-5532-6743
CN
Arrington
Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, 4849 Calhoun Rd Rm 373, Houston, TX, 77204-6022, USA.
Ashley L
AL
Ware
Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, 4849 Calhoun Rd Rm 373, Houston, TX, 77204-6022, USA.
Yusra
Y
Ahmed
Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, 4849 Calhoun Rd Rm 373, Houston, TX, 77204-6022, USA.
Paulina A
PA
Kulesz
Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.
Maureen
M
Dennis
Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, 4849 Calhoun Rd Rm 373, Houston, TX, 77204-6022, USA.
Jack M
JM
Fletcher
D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D003072:Cognition Disorders / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology* / Q000601:surgery*; D007360:Intelligence / Q000502:physiology*; D012086:Reoperation / Q000379:methods*
Congenital hydrocephalus; Intelligence (IQ); Shunt revisions; Shunting