Hemangiomas and vascular malformations: analysis of diagnostic accuracy.
OBJECTIVE
To evaluate the diagnostic accuracy and satisfaction of patient or family (or both) in the evaluation of hemangiomas and other vascular malformations.


METHODS
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.
Very
Mark
M
Department of Pediatric Surgical Services, The Children's Hospital of Buffalo, New York 14222, USA.
Nagy
Mark
M
Carr
Michelle
M
Collins
Sandy
S
Brodsky
Linda
L
D001165:Arteriovenous Malformations / Q000175:diagnosis*; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies