关于治疗婴儿血管瘤的观察者间和观察者内部协议
María Colmenero-Sendra1,2, Javier Del Boz-González3, Mercè Grau-Pérez4,5
1Dermatology Department, Hospital Costa del Sol, Marbella, Spain.
JAMA dermatology
|December 18, 2024
概括
儿科皮肤科医生在婴儿血管瘤 (IH) 治疗方面表现出公平的共识,对于低风险的IH有显著的变化. 需要更多关于局部提摩洛尔的证据,以在全球范围内标准化IH管理.
科学领域:
- 皮肤病学 皮肤病学
- 儿科 儿科 儿科
- 临床实践指南 临床实践指南
背景情况:
- 婴儿血管瘤 (IHs) 的临床实践指南存在,但显示异质性.
- 在全球范围内,IH管理实践的显著差异已被报告.
研究的目的:
- 评估北美和欧洲儿科皮肤科医生之间的婴儿血管瘤 (IHs) 治疗选择协议.
- 为了确定协议水平是否根据IH风险类别不同.
主要方法:
- 一项涉及北美和欧洲90名儿科皮肤科医生的横截面调查研究.
- 参与者评估了50个IH细节,并选择了治疗选择:兰醇,局部蒂莫洛尔或观察.
- 该调查进行了两次,间隔一个月,以评估使用Gwet AC1系数的interrater和intrarater协议.
主要成果:
- 对IH治疗的全球观察者间一致性是公平的 (AC1,0.38).
- 在北美 (AC1,0.41) 的同意程度适度,在欧洲 (AC1,0.37) 的同意程度相当.
- 根据风险而异的协议:对于高风险的IH非常好,对于中等风险和低风险的IH中等. 普罗普拉诺洛尔在高风险的IH中受到青,在低风险的IH中观察.
结论:
- 在治疗中等风险和低风险婴儿血管瘤 (IHs) 中存在显著的变异性.
- 研究结果强调需要进一步研究局部提摩洛尔的作用,以提高全球IH治疗的一致性.
- 标准化IH管理需要更多的证据和可能更新的临床指南.
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