Diagnosing Cerebrospinal Fluid Shunt Failure: Systematic Review and Meta-Analysis of Noninvasive and Minimally Invasive Tests in Children and Adults

This is the largest systematic review and meta-analysis conducted to date to analyze the performance of minimally invasive tools to diagnose shunt failure. None of the tests performed well enough to be considered a stand-alone test for the diagnosis of shunt failure, and only X-ray shunt series performed significantly different than CT. Limitations include the high risk of bias in the reference standard domain for most studies as identified using Quality Assessment Tool for Diagnostic Accuracy Studies-2.