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An interdisciplinary specialist team leads to improved diagnostics and treatment for paediatric patients with
Katariina A Mattila1, Kaisa Kervinen1, Teija Kalajoki-Helmiö2
1Department of Paediatric Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
An interdisciplinary team improved diagnosis and treatment for paediatric vascular anomalies. While haemangiomas were often correctly identified, other vascular tumours and malformations were frequently misdiagnosed, potentially delaying care.
Area of Science:
- Paediatric vascular anomalies
- Interdisciplinary medical care
Background:
- Vascular anomalies in children are frequently misdiagnosed, leading to suboptimal treatment outcomes.
- Accurate and timely diagnosis is critical for effective management of these complex conditions.
Purpose of the Study:
- To assess the impact of an interdisciplinary team approach on the diagnosis and treatment of paediatric patients with vascular anomalies.
- To evaluate the accuracy of diagnoses and the appropriateness of treatments for vascular anomalies in a paediatric cohort.
Main Methods:
- Retrospective review of 480 paediatric patients evaluated by an interdisciplinary team from 2002 to 2012.
- Analysis included referral and final diagnoses, patient demographics, clinical history, diagnostic tests, and treatment outcomes.
Main Results:
- Of 435 patients with vascular anomalies, 30.7% had tumours (93.2% haemangiomas) and 55.2% had malformations.
- Tumours were diagnosed correctly in 89.2% of cases, whereas malformations were correctly diagnosed in only 38.0%.
- Incorrect diagnoses led to improper treatment in 1.4% of patients, with delays suspected in many more.
Conclusions:
- Haemangiomas are generally diagnosed accurately, but other vascular tumours and malformations are prone to misdiagnosis.
- While direct improper treatment was rare, misdiagnosis likely caused significant treatment delays.
- An interdisciplinary team approach enhances diagnostic accuracy and improves treatment for paediatric vascular anomalies.
Aim:
Patients with vascular anomalies are often misdiagnosed, leading to delayed or improper treatment. The aim of this study was to evaluate the impact of an interdisciplinary team on the diagnosis and treatment of paediatric patients with vascular anomalies.
Methods:
We reviewed the paediatric patients evaluated by our interdisciplinary team between 2002 and 2012, analysing the referral diagnosis, final diagnosis, patient age, sex, clinical history, laboratory tests, imaging studies and treatments.
Results:
Of the 480 patients who were evaluated, 435 (90.6%) had a vascular anomaly: 30.7% of all patients had a tumour and 55.2% had a malformation. Haemangiomas comprised 93.2% of all tumours, while malformations included capillary (9.8%), lymphatic (30.1%), venous (36.8%), arteriovenous (3.8%) and combined slow-flow (7.9%) malformations. Tumours were initially diagnosed correctly in 89.2% of the patients, but only 38.0% of the malformations were diagnosed correctly. Improper treatment was given to 1.4%, due to incorrect diagnoses.
Conclusion:
This study showed that haemangiomas were likely to be diagnosed correctly, but other tumours and vascular malformations were likely to be misdiagnosed. Misdiagnosis seldom led to improper treatment, but probably led to delayed treatment in many cases. The interdisciplinary approach led to improved diagnostics and treatment.
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