Long-term follow-up is often recommended for patients with hydrocephalus, but the frequency of clinical follow-up, timing and modality of imaging, and duration of surveillance have not been clearly defined. Here, the authors used the modified Delphi method to identify areas of consensus regarding the modality, frequency, and duration of hydrocephalus surveillance following surgical treatment.

Pediatric neurosurgeons serving as institutional liaisons to the Hydrocephalus Clinical Research Network (HCRN), or its implementation/quality improvement arm (HCRNq), were invited to participate in this modified Delphi study. Thirty-seven consensus statements were generated and distributed via an anonymous electronic survey, with responses structured as a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). A subsequent, virtual meeting offered the opportunity for open discussion and modification of the statements in an effort to reach consensus (defined as ≥ 80% agreement or disagreement).

Nineteen pediatric neurosurgeons participated in the first round, after which 15 statements reached consensus. During the second round, 14 participants met virtually for review and discussion. Some statements were modified and 2 statements were combined, resulting in a total of 36 statements. At the conclusion of the session, consensus was achieved for 17 statements regarding the following: 1) the role of standardization; 2) preferred imaging modalities; 3) postoperative follow-up after shunt surgery (subdivided into immediate postoperative imaging, delayed postoperative imaging, routine clinical surveillance, and routine radiological surveillance); and 4) postoperative follow-up after an endoscopic third ventriculostomy. Consensus could not be achieved for 19 statements.

Using the modified Delphi method, 17 consensus statements were developed with respect to both clinical and radiological follow-up after a shunt or endoscopic third ventriculostomy. The frequency, modality, and duration of surveillance were addressed, highlighting areas in which no clear data exist to guide clinical practice. Although further studies are needed to evaluate the clinical utility and cost-effectiveness of hydrocephalus surveillance, the current study provides a framework to guide future efforts to develop standardized clinical protocols for the postoperative surveillance of patients with hydrocephalus. Ultimately, the standardization of hydrocephalus surveillance has the potential to improve patient care as well as optimize the use of healthcare resources.

通常建议对脑积水患者进行长期随访，但临床随访的频率、成像的时间和方式以及监测的持续时间尚未明确定义。在这里，作者使用改进的 Delphi 方法来确定关于手术治疗后脑积水监测的方式、频率和持续时间的共识领域。

作为脑积水临床研究网络 (HCRN) 或其实施/质量改进部门 (HCRNq) 的机构联络员的儿科神经外科医生被邀请参加这项修改后的德尔福研究。通过匿名电子调查生成并分发了 37 份共识声明，响应结构为李克特 4 点量表（非常同意、同意、不同意、非常不同意）。随后的虚拟会议提供了公开讨论和修改声明的机会，以达成共识（定义为 ≥ 80% 的同意或不同意）。

19 名儿科神经外科医生参加了第一轮，之后 15 项声明达成共识。在第二轮中，14 名参与者进行了虚拟会议进行审查和讨论。修改了部分语句，合并了2条语句，总共有36条语句。在会议结束时，就以下方面的 17 项声明达成了共识： 1）标准化的作用；2) 首选的成像方式；3）分流术后的术后随访（细分为术后即刻影像、术后延迟影像、常规临床监测、常规影像学监测）；4) 内镜下第三脑室造口术后的术后随访。19 项声明未能达成共识。

使用改良的 Delphi 方法，就分流术或内窥镜第三脑室造口术后的临床和放射学随访制定了 17 个共识声明。讨论了监测的频率、方式和持续时间，突出了没有明确数据指导临床实践的领域。尽管需要进一步的研究来评估脑积水监测的临床效用和成本效益，但目前的研究提供了一个框架来指导未来制定标准化临床方案以对脑积水患者进行术后监测。最终，脑积水监测的标准化有可能改善患者护理并优化医疗资源的使用。