Fig. 2.

Network meta-analysis for overall complications. (A) Network plot showing the structure of available evidence across timing strategies. Nodes represent treatment strategies (pre-, simultaneous, and post-CP VPS), with node size proportional to the number of patients in each group and edge thickness reflecting the number of direct comparisons between strategies. (B) P score radar plot demonstrating the relative ranking of each strategy for overall complications (scale 0–1), where higher values indicate a greater probability of being the best-performing (lowest complication risk) strategy. (C) League table heatmap showing pooled pairwise risk ratios (RRs) with 95% confidence intervals for all comparisons. Values > 1 indicate higher complication risk in the row-defining strategy relative to the column-defining comparator, whereas values < 1 favor the row strategy. Color intensity reflects the magnitude of effect. Abbreviations: Pre = Ventriculoperitoneal shunt placement prior to cranioplasty. Simultaneous = Ventriculoperitoneal shunt placement at the time of cranioplasty. Post = Ventriculoperitoneal shunt placement after cranioplasty