Very Mark, Nagy Mark, Carr Michelle, Collins Sandy, Brodsky Linda
Department of Pediatric Surgical Services, The Children's Hospital of Buffalo, New York 14222, USA.
Laryngoscope. 2002 Apr;112(4):612-5. doi: 10.1097/00005537-200204000-00004.
To evaluate the diagnostic accuracy and satisfaction of patient or family (or both) in the evaluation of hemangiomas and other vascular malformations.
Prospective, relational database.
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.
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.
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.
评估在血管瘤和其他血管畸形评估中患者或家属（或两者）的诊断准确性及满意度。
前瞻性关系数据库研究。
1998年7月至2000年4月，98名患者参与了一项前瞻性、经机构审查委员会批准的关系数据库研究，该研究在纽约州布法罗市儿童医院的血管瘤和血管胎记中心进行。其中包括68例血管瘤患者和30例血管畸形患者。获取了关于初始诊断、最终诊断以及患者或家属（或两者）满意度的数据。
诊断准确性分析显示，仅37%的病例中初始诊断与最终基于临床和磁共振成像的联合诊断一致。对患者及家属对之前咨询医生所提供治疗的满意度分析显示，仅有26%“完全”满意，26%“有些”满意，37%“一点也不”满意。在患者或家属（或两者）感到满意之前，平均有2.5名（标准差 = 1.6；范围为1 - 9；中位数为2）不同的医生看过该患者。
对医生而言，准确诊断血管瘤和血管畸形仍然是一项挑战。术语混淆、对病变行为缺乏了解以及医生对诊断标准理解不足是导致患者沮丧的部分原因。通过改善沟通对初级保健提供者进行教育，有助于优化针对患有血管异常的患者及其家属的协调、跨学科方法。
