Kim TY, Brown L, Stewart GM.. "Test characteristics of parents visual analog scale score in predicting ventriculoperitoneal shunt malfunction in the pediatric emergency department.." Pediatric Emergency Care . (): -. (*)
Objectives: Many parents of children with ventriculoperitoneal shunts present to the emergency department for evaluation of a possible shunt malfunction. No study to date has evaluated their ability to predict a shunt malfunction. Our study objective was to evaluate parents? accuracy for predicting a shunt malfunction in their child. We hypothesized that parents, more experienced with prior shunt malfunctions are better able to predict subsequent malfunctions in their child.
Methods: We conducted a prospective, descriptive study on children aged < 18 years presenting to our tertiary care pediatric emergency department with a possible ventriculoperitoneal shunt malfunction. Parents rated the likelihood of a shunt malfunction using an unmarked 100 mm visual analog scale (VAS) marked ?definitely malfunctioning? at the high end. An experienced parent was defined as one who had previously experienced at least 3 shunt malfunctions in their child.
Results: We enrolled 85 parent-child dyads in our study. Twenty-four children were diagnosed with a malfunction. The best combination of sensitivity and specificity among the inexperienced parents was found at a VAS score of ≥ 53 (sensitivity 53.3%, specificity 58.3%) vs. ≥ 76 (sensitivity 77.8%, specificity 81.1%) in the experienced parents.. Experienced parents showed an area under the curve of 0.7928 [95% CI (0.6037, 0.9819)] and inexperienced parents 0.5611 [95% CI (0.3646, 0.7576)], p = 0.096.
Conclusions: Experienced parents are better able to predict a shunt malfunction in their child.