Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure: a systematic review and meta-analysis protocol

Alex Koziarz, Niv Sne, Fraser Kegel, Waleed Alhazzani, Siddharth Nath, Jetan H Badhiwala, Timothy Rice, Paul Engels, Faidi Samir, Andrew Healey, Kamyar Kahnamoui, Laura Banfield, Sunjay Sharma, Kesava Reddy, Gregory W J Hawryluk, Andrew W Kirkpatrick, Saleh A Almenawer, Alex Koziarz, Niv Sne, Fraser Kegel, Waleed Alhazzani, Siddharth Nath, Jetan H Badhiwala, Timothy Rice, Paul Engels, Faidi Samir, Andrew Healey, Kamyar Kahnamoui, Laura Banfield, Sunjay Sharma, Kesava Reddy, Gregory W J Hawryluk, Andrew W Kirkpatrick, Saleh A Almenawer

Abstract

Introduction: Increased intracranial pressure (ICP) is a significant neurological issue that may lead to permanent neurological sequelae. When evaluating patients with traumatic brain injury, it is crucial to identify those with high ICP in order to expedite ICP lowering measures and maintain adequate cerebral perfusion. Several measures are used to recognise patients with increased ICP including CT scan, MRI, ICP monitor, and lumbar puncture (LP). However, these tests can be invasive, associated with radiation exposure, contraindicated, or not readily available. Ultrasonography measurement of the optic nerve sheath diameter (ONSD) is proposed as a non-invasive and quick measure to identify high ICP. The aim of this systematic review and meta-analysis will be to examine the accuracy of ONSD sonography for increased ICP diagnosis.

Methods and analyses: We will include published and unpublished randomised controlled trials, observational studies, and abstracts, with no publication type or language restrictions. Search strategies will be designed to peruse the MEDLINE, Embase, Web of Science, WHO Clinical Trials, ClinicalTrials.gov, CINAHL, and the Cochrane Library databases. We will also implement strategies to search grey literature. Two reviewers will independently complete data abstraction and conduct quality assessment. Included studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We will construct the hierarchical summary receiver operating characteristic curve for included studies and pool sensitivity and specificity using the bivariate model. We also plan to conduct prespecified subgroup analyses to explore heterogeneity. The overall quality of evidence will be rated using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Ethics and dissemination: Research ethics board approval is not required for this study as it draws from published data and raises no concerns related to patient privacy. This review will provide a comprehensive assessment of the evidence on ONSD sonography diagnostic accuracy and is directed to a wide audience. Results from the review will be disseminated extensively through conferences and submitted to a peer-reviewed journal for publication.

Prospero registration number: CRD42017055485.

Clinical trial number: Trial registration number is NCT00783809.

Keywords: Increased Intracranial Pressure; optic nerve sheath diameter sonography; severe head injury; ultrasound.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flowchart of study selection.

References

    1. Zanier ER, Ortolano F, Ghisoni L, et al. . Intracranial pressure monitoring in intensive care: clinical advantages of a computerized system over manual recording. Crit Care 2007;11:R7 10.1186/cc5155
    1. Dunn LT. Raised intracranial pressure. Journal of Neurology, Neurosurgery & Psychiatry 2002;73(suppl 1):i23–i27. 10.1136/jnnp.73.suppl_1.i23
    1. Joseph B, Haider AA, Pandit V, et al. . Changing paradigms in the management of 2184 patients with traumatic brain injury. Ann Surg 2015;262:440–8. 10.1097/SLA.0000000000001418
    1. Mayhall CG, Archer NH, Lamb VA, et al. . Ventriculostomy-Related infections. N Engl J Med 1984;310:553–9.
    1. Wang L, Feng L, Yao Y, et al. . Optimal optic nerve sheath diameter threshold for the identification of elevated opening pressure on lumbar puncture in a Chinese population. PLoS One 2015;10:e0117939 10.1371/journal.pone.0117939
    1. Amin D, McCormick T, Mailhot T. Elevated intracranial pressure diagnosis with Emergency Department Bedside ocular ultrasound. Case Rep Emerg Med 2015;2015:1–3. 10.1155/2015/385970
    1. Tayal VS, Neulander M, Norton HJ, et al. . Emergency department sonographic measurement of optic nerve sheath diameter to detect findings of increased intracranial pressure in adult head injury patients. Ann Emerg Med 2007;49:508–14. 10.1016/j.annemergmed.2006.06.040
    1. Liberati A, Altman DG, Tetzlaff J, et al. . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700 10.1136/bmj.b2700
    1. Moher D, Liberati A, Tetzlaff J, et al. . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535 10.1136/bmj.b2535
    1. Macaskill P, Gatsonis C, Deeks JJ, et al. . Chapter 10: Analysing and Presenting Results : Deeks JJ, Bossuyt PM, Gatsonis C, Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 1.0. The Cochrane Collaboration, 2010. .
    1. Sollenberger JF, Holloway RG. The evolving role and value of libraries and librarians in health care. JAMA 2013;310:1231–2. 10.1001/jama.2013.277050
    1. Golshani K, Ebrahim Zadeh M, Farajzadegan Z, et al. . Diagnostic accuracy of Optic Nerve Ultrasonography and Ophthalmoscopy in prediction of elevated intracranial pressure. Emerg 2015;3:54–8.
    1. Whiting PF, Rutjes AW, Westwood ME, et al. . QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011;155:529–36. 10.7326/0003-4819-155-8-201110180-00009
    1. Hansen HC, Helmke K. The subarachnoid space surrounding the optic nerves. an ultrasound study of the optic nerve sheath. Surg Radiol Anat 1996;18:323–8. 10.1007/BF01627611
    1. Hansen HC, Helmke K, Kunze K. Optic Nerve Sheath Enlargement in acute intracranial hypertension. Neuro-ophthalmology 1994;14:345–54. 10.3109/01658109409024061
    1. Helmke K, Hansen HC. Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. I: experimental study. Pediatr Radiol 1996;26:701–5. 10.1007/BF01383383
    1. Said RR, Rosman NP. A negative cranial computed tomographic scan is not adequate to support a diagnosis of pseudotumor cerebri. J Child Neurol 2004;19:609–13. 10.1177/088307380401900808
    1. Carney N, Totten AM, OʼReilly C, et al. . Guidelines for the management of severe traumatic brain injury, Fourth Edition. Neurosurgery 2016:1 (Epub ahead of print). 10.1227/NEU.0000000000001432
    1. Reitsma JB, Glas AS, Rutjes AW, et al. . Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol 2005;58:982–90. 10.1016/j.jclinepi.2005.02.022
    1. Rutter CM, Gatsonis CA. A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stat Med 2001;20:2865–84. 10.1002/sim.942
    1. Lee J, Kim KW, Choi SH, et al. . Systematic review and Meta-Analysis of studies evaluating diagnostic test Accuracy: a Practical Review for clinical Researchers-Part II. statistical methods of Meta-Analysis. Korean J Radiol 2015;16:1188–96. 10.3348/kjr.2015.16.6.1188
    1. Bossuyt P B, Davenport C, Deeks J, et al. . Chapter 11: Interpreting results and drawing conclusions : Deeks JJ, Bossuyt PM, Gatsonis C, Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 0.9. The Cochrane Collaboration, 2013. .
    1. Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication Bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 2005;58:882–93. 10.1016/j.jclinepi.2005.01.016
    1. Schünemann HJ, Schünemann AH, Oxman AD, et al. . Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ 2008;336:1106–10. 10.1136/

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