Journal article
The Infantile Hemangioma Referral Score: A Validated Tool for Physicians.
- Léauté-Labrèze C Department of Dermatology, Pellegrin Children's Hospital, Bordeaux, France; christine.labreze@chu-bordeaux.fr.
- Baselga Torres E Department of Dermatology, Universitat Autònoma de Barcelona and Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- Weibel L Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.
- Boon LM Center for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires St Luc, Brussels, Belgium.
- El Hachem M Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
- van der Vleuten C Expertise Center for Hemangioma and Vascular Malformations, Department of Dermatology, Radboud University Medical Center, Nijmegen, Netherlands.
- Roessler J Center of Pediatrics and Adolescent Medicine, Medical Center-University Freiburg, Freiburg, Germany; and.
- Troilius Rubin A Centre for Laser and Vascular Anomalies, Department of Dermatology, Skåne University Hospital, Malmö, Sweden.
- 2020-03-13
Published in:
- Pediatrics. - 2020
Advisory Committees
Algorithms
Confidence Intervals
Cross-Sectional Studies
Hemangioma
Humans
Infant
Observer Variation
ROC Curve
Referral and Consultation
Reproducibility of Results
Sensitivity and Specificity
Surveys and Questionnaires
English
OBJECTIVES
Infantile hemangiomas (IHs) are common; some cases require timely referral and treatment to prevent complications. We developed and validated a reliable instrument for timely and adequate referral of patients with IH to experts by nonexpert primary physicians.
METHODS
In this multicenter, cross-sectional, observational study, we used a 3-stage process: (1) development of the Infantile Hemangioma Referral Score (IHReS) tool by IH experts who selected a representative set of 42 IH cases comprising images and a short clinical history, (2) definition of the gold standard for the 42 cases by a second independent committee of IH experts, and (3) IHReS validation by nonexpert primary physicians using the 42 gold standard cases.
RESULTS
A total of 60 primary physicians from 7 different countries evaluated the 42 gold standard cases (without reference to the IHReS tool); 45 primary physicians evaluated these cases using the IHReS questionnaire, and 44 completed retesting using the instrument. IHReS had a sensitivity of 96.9% (95% confidence interval 96.1%-97.8%) and a specificity of 55.0% (95% confidence interval 51.0%-59.0%). The positive predictive value and negative predictive value were 40.5% and 98.3%, respectively. Validation by experts and primary physicians revealed substantial agreement for interrater reliability and intrarater repeatability.
CONCLUSIONS
IHReS, a 2-part algorithm with a total of 12 questions, is an easy-to-use tool for primary physicians for the purpose of facilitating correct and timely referral of patients with IH. IHReS may help practitioners in their decision to refer patients to expert centers.
Infantile hemangiomas (IHs) are common; some cases require timely referral and treatment to prevent complications. We developed and validated a reliable instrument for timely and adequate referral of patients with IH to experts by nonexpert primary physicians.
METHODS
In this multicenter, cross-sectional, observational study, we used a 3-stage process: (1) development of the Infantile Hemangioma Referral Score (IHReS) tool by IH experts who selected a representative set of 42 IH cases comprising images and a short clinical history, (2) definition of the gold standard for the 42 cases by a second independent committee of IH experts, and (3) IHReS validation by nonexpert primary physicians using the 42 gold standard cases.
RESULTS
A total of 60 primary physicians from 7 different countries evaluated the 42 gold standard cases (without reference to the IHReS tool); 45 primary physicians evaluated these cases using the IHReS questionnaire, and 44 completed retesting using the instrument. IHReS had a sensitivity of 96.9% (95% confidence interval 96.1%-97.8%) and a specificity of 55.0% (95% confidence interval 51.0%-59.0%). The positive predictive value and negative predictive value were 40.5% and 98.3%, respectively. Validation by experts and primary physicians revealed substantial agreement for interrater reliability and intrarater repeatability.
CONCLUSIONS
IHReS, a 2-part algorithm with a total of 12 questions, is an easy-to-use tool for primary physicians for the purpose of facilitating correct and timely referral of patients with IH. IHReS may help practitioners in their decision to refer patients to expert centers.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1542/peds.2019-1628
- PMID 32161112
- Persistent URL
- https://sonar.ch/global/documents/260824
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