{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:22:06Z","timestamp":1787757726940,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n The use of programmable ventriculoperitoneal shunt (P-VPS) in idiopathic normal pressure hydrocephalus (iNPH) has increased over the last two decades, however, there is no definitive evidence to favor them over non-programmable VPS (NP-VPS). Thus, there is a growing need for studies comparing these two procedures for their efficacy and safety profile in iNPH.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n In this study, we attempt to quantitatively summarize the findings of all the prospective and retrospective studies that have directly compared the P-VPS and NP-VPS in terms of efficacy, complications, or overall healthcare expenditure.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A systematic search was performed of PubMed, the Cochrane Library databases, and Google Scholar for studies till June 2021 comparing the outcomes of P-VPS with NP-VPS. Four studies were finally included in the quantitative analysis. A trial sequential analysis was done to evaluate the need for further studies.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The total rates of subdural collection (odds ratio (OR) 1.03; 95% Confidence interval (CI): 0.73\u20131.46;\n P<\/jats:italic>\n = 0.85;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 12%) as well as surgically evacuated subdural collection (OR 0.46; 95% CI: 0.14\u20131.55;\n P<\/jats:italic>\n = 0.21;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 75%) were not significantly different for P-VPS compared to NP-VPS with pooled data. Similarly, the rate of postoperative infection was found to be similar between the two types of VPS (OR 0.98; 95% CI: 0.39\u20132.5;\n P<\/jats:italic>\n = 0.97;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 0%). The trial sequential analysis (TSA) for the need of surgical evacuation of subdural collection and shunt revision revealed that the meta-analysis of the currently accrued information is not conclusive.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Though, associated with higher initial costs, P-VPS does not seem to result in increased healthcare costs in the long run while enabling the surgeon to titrate the opening pressure and avoiding additional surgical procedures like shunt revision or evacuation of subdural collection at least theoretically. However, further trials with a greater sample size are needed to confirm these findings as the current accrued information size is insufficient to reach an unequivocal verdict.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0028-3886.332277","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:37:09Z","timestamp":1640655429000},"page":"S413-S419","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of Programmable and Non-Programmable Shunts for Normal Pressure Hydrocephalus"],"prefix":"10.4103","volume":"69","author":[{"given":"Varidh","family":"Katiyar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Tandon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanwaljeet","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Narwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Sarat","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Suri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank S","family":"Kale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-25-20240907","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.3171\/2018.5.JNS1875","article-title":"Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: A systematic review and meta-analysis","volume":"131","author":"Giordan","year":"2019","journal-title":"J Neurosurg"},{"key":"R2-25-20240907","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/S0090-3019(00)00224-X","article-title":"Primary intracranial germinoma in the medulla oblongata","volume":"53","author":"Nakajima","year":"2000","journal-title":"Surg Neurol"},{"key":"R4-25-20240907","doi-asserted-by":"crossref","first-page":"687","DOI":"10.3171\/jns.1997.87.5.0687","article-title":"Dutch normal-pressure hydrocephalus study: Prediction of outcome after shunting by resistance to outflow of cerebrospinal 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cost-benefit analysis in Turkey","volume":"96","author":"Serarslan","year":"2017","journal-title":"Medicine"},{"key":"R8-25-20240907","doi-asserted-by":"crossref","first-page":"944","DOI":"10.4103\/0028-3886.263213","article-title":"Cerebrospinal fluid dynamics study in clinical practice","volume":"67","author":"Ramesh","year":"2019","journal-title":"Neurol India"},{"key":"R9-25-20240907","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.4103\/0028-3886.241406","article-title":"Change in average peak cerebrospinal fluid velocity at the cerebral aqueduct, before and after lumbar CSF tapping by the use of phase contrast MRI, and its effect on gait improvement in patients with normal pressure hydrocephalus","volume":"66","author":"Gokul","year":"2018","journal-title":"Neurol India"},{"key":"R10-25-20240907","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.3171\/2014.7.JNS14283","article-title":"A randomized controlled dual-center trial on shunt complications in idiopathic normal-pressure hydrocephalus treated with gradually reduced or \u201cfixed\u201d pressure valve settings","volume":"121","author":"S\u00e6hle","year":"2014","journal-title":"J Neurosurg"},{"key":"R11-25-20240907","doi-asserted-by":"crossref","first-page":"797","DOI":"10.3171\/2017.5.JNS17481","article-title":"Subdural hematomas in 1846 patients with shunted idiopathic normal pressure hydrocephalus: Treatment and long-term survival","volume":"129","author":"Sundstr\u00f6m","year":"2018","journal-title":"J Neurosurg"},{"key":"R12-25-20240907","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.4103\/0028-3886.246234","article-title":"Cerebral interstitial fluid impairment syndrome","volume":"66","author":"Panciani","year":"2018","journal-title":"Neurol India"},{"key":"R14-25-20240907","doi-asserted-by":"crossref","first-page":"359","DOI":"10.3171\/2015.1.JNS141301","article-title":"A double-blind randomized trial on the clinical effect of different shunt valve settings 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