Patients diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH) typically experience symptom improvements after undergoing a cerebrospinal fluid-tap test (CSF-TT), These improvements are recognized as indicative of potential improvements following surgical intervention. As gait disturbance is the most common iNPH symptom, gait improvements are of predominant interest. The purpose of this study was to examine if clinically important changes in gait and balance from CSF-TT predict meaningful changes following surgery. The study involved analysis of data collected in a prospective observational study for 34 iNPH patients who underwent a CSF-TT and subsequent surgery. Linear regression, logistic regression and classification trees were used for predictive modelling comparing changes from CSF-TT with post-surgical changes in Tinetti, Timed Up and Go (TUG) and Berg Balance Scale (BBS) outcomes. Predictive models for minimal clinically important differences (MCIDs) from CSF-TT to surgery were significant for Tinetti (odds ratio = 1.42, = 0.02) and BBS (odds ratio = 1.57, < 0.01). Four items on Tinetti and two items on BBS were identified with a predictive accuracy of 79% and 76% respectively. BBS has the highest sensitivity (85%) and negative predictive value (77%). TUG had a 100% specificity and 100% positive predictive value. The predictive model using MCIDs for TUG was not significant (odds ratio = 1.13, = 0.06). Clinically important changes from CSF-TT are useful in predicting post-surgical outcomes in iNPH patients. Tinetti and BBS, both have predictive value using MCID scores as cut off values, of which BBS is a stronger outcome measure for prediction.

中文翻译：

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利用脑脊液抽液试验的临床重要变化预测特发性正常压力脑积水的术后结果

诊断为特发性正常压力脑积水 (iNPH) 的患者在接受脑脊液抽液测试 (CSF-TT) 后通常会出现症状改善。这些改善被认为表明手术干预后可能会出现改善。由于步态障碍是最常见的 iNPH 症状，因此步态改善是最受关注的。本研究的目的是检查 CSF-TT 的步态和平衡的临床重要变化是否可以预测手术后有意义的变化。该研究对一项前瞻性观察研究中收集的数据进行了分析，该研究针对 34 名接受 CSF-TT 和后续手术的 iNPH 患者。使用线性回归、逻辑回归和分类树进行预测建模，比较 CSF-TT 的变化与 Tinetti、Timed Up and Go (TUG) 和 Berg Balance Scale (BBS) 结果的术后变化。从 CSF-TT 到手术的最小临床重要差异 (MCID) 的预测模型对于 Tinetti（比值比 = 1.42，= 0.02）和 BBS（比值比 = 1.57，< 0.01）具有显着意义。 Tinetti 上的四个项目和 BBS 上的两个项目的预测准确度分别为 79% 和 76%。 BBS 具有最高的敏感性（85%）和阴性预测值（77%）。 TUG 具有 100% 的特异性和 100% 的阳性预测值。使用 MCID 进行 TUG 的预测模型并不显着（比值比 = 1.13，= 0.06）。 CSF-TT 的临床重要变化有助于预测 iNPH 患者的术后结果。 Tinetti 和 BBS 都具有使用 MCID 分数作为截止值的预测价值，其中 BBS 是预测的更强的结果衡量标准。