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Hemangiomas and Vascular Malformations: Analysis of Diagnostic Accuracy
Author(s) -
Very Mark,
Nagy Mark,
Carr Michelle,
Collins Sandy,
Brodsky Linda
Publication year - 2002
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200204000-00004
Subject(s) - medicine , birthmark , hemangioma , vascular malformation , prospective cohort study , terminology , magnetic resonance imaging , pediatrics , radiology , surgery , dermatology , linguistics , philosophy
Objectives To evaluate the diagnostic accuracy and satisfaction of patient or family (or both) in the evaluation of hemangiomas and other vascular malformations. Study Design Prospective, relational database. Methods Ninety‐eight patients participated in a prospective, Institutional Review Board–approved, relational database study in the Hemangioma and Vascular Birthmark Center at the Children's Hospital of Buffalo (Buffalo, NY) from July 1998 to April 2000. This included 68 patients with hemangiomas and 30 with vascular malformations. Data regarding presenting and final diagnosis and satisfaction of patient or family (or both) were obtained. Results Analysis of diagnostic accuracy revealed a concurrence between initial and final combined clinical and magnetic resonance imaging–based diagnosis in only 37% of cases. Analysis of patient and family satisfaction with the care received from previous consultants revealed only 26% “entirely” satisfied, 26% “somewhat” satisfied, and 37% “not at all” satisfied. On average, 2.5 (SD = 1.6; range, 1–9; median, 2) different physicians saw the patient before the patient or family (or both) was satisfied. Conclusions Accurate diagnosis of hemangiomas and vascular malformations remains a challenge for physicians. Confusing terminology, lack of knowledge regarding lesion behavior, and poorly understood diagnostic criteria by physicians are some of the reasons for patient frustration. Education of primary care providers through improved communication helps to optimize a coordinated, interdisciplinary approach to patients and their families who present with vascular anomalies.