Abstract
Introduction: This study aimed to develop and validate a reliable, multidomain scale for assessing childhood hydrocephalus severity and to enhance communication, guide treatment decisions, and improve patient care. Methods: A stepwise consensus approach informed by a modified Delphi technique was employed. Healthcare professionals participated in anonymous surveys and face-to-face meetings to define the core domains of the scale. Content validity, internal consistency, and inter-rater reliability were assessed. Results: The Delphi process yielded a refined 7-item, 10-point Childhood Hydrocephalus Severity Scale (CHS) focusing on age, Evans index, associated malformations, neurological deficit, intraventricular hemorrhage, and mid-arm circumference. Content validity analysis using the Content Validity Index (CVI) demonstrated strong agreement (mean I-CVI = 0.91) among experts regarding the relevance of CHS items. All individual item CVI scores exceeded 0.8, supporting the inclusion of each factor. The CHS exhibited excellent internal consistency (Cronbach’s alpha = 0.988). High intraclass correlation coefficients (ICCs) were observed for both single measures (ICC = 0.902, 95% CI: 0.862–0.931) and average measures (ICC = 0.985, 95% CI: 0.978–0.990), indicating near-perfect agreement between raters. Both ICC values were statistically significant (p < 0.001). Conclusion: The CHS demonstrates promising potential as a reliable and valid tool for childhood hydrocephalus severity assessment. This scale has the potential to enhance communication, guide treatment decisions, and improve patient care in childhood hydrocephalus.
Plain Language Summary
Hydrocephalus in children results from excessive fluid buildup in the brain. Current methods for assessing its severity often provide an incomplete picture of a child’s condition, especially before intervention. This study developed a new scale called the Childhood Hydrocephalus Severity Scale (CHS) to address this limitation. Unlike traditional methods that focus solely on single parameters like head size, the CHS considers multiple factors, including the child’s age, brain imaging findings, other brain abnormalities, and nutritional status. Experts collaborated to create and refine the CHS, and rigorous testing confirmed its accuracy and reliability. The results demonstrate that the CHS can effectively measure hydrocephalus severity, providing valuable insights for doctors to enhance treatment planning and improve patient care. By offering families a clearer understanding of their child’s condition, the CHS can also empower them to participate more actively in decision-making. Ultimately, the widespread use of the CHS has the potential to significantly improve outcomes for children with hydrocephalus.
