Baseline Description of the Spanish Academy of Dermatology Infantile Haemangioma Nationwide Prospective Cohort. Comparison of Patients Treated with Propranolol in Routine Clinical Practice with Previous Pivotal Clinical Trial Data

Cuenca‐Barrales, Carlos; Baselga-Torres, E.; Boz-González, J. del; Vicente, A.; Palencia-Pérez, S I; Campos‐Domínguez, Minia; Valdivieso-Ramos, M.; Martín‐Santiago, A.; Montserrat-García, María Teresa; Azón-Masoliver, A; Feito-Rodríguez, M.; Domínguez-Cruz, J.J.; Roé-Crespo, Esther; Salas-Marquez, C.; Giacaman, A.; Lorente-Lavirgen, A.I.; Quintana‐Castanedo, Lucía; Vega-Martínez, Marina de; García‐Doval, I.; Bernabéu‐Wittel, José

doi:10.1016/j.adengl.2021.08.001

Cited by 1 publication

(3 citation statements)

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“…The main limitations of our study are those inherent to the use of vignettes. Comparing results from our survey vignettes to those of clinical practice from the Spanish Registry, 22 we observed the election of propranolol in a higher percentage of patients in our survey (28% vs 12%). This discrepancy could lie in a greater ability to adhere to protocols in a simulated situation compared to reality 23 .…”

Section: Discussionmentioning

confidence: 52%

“…19,20 The therapeutic choice of each dermatologist in non-high-risk IH might be influenced by their own experience, 21 The main limitations of our study are those inherent to the use of vignettes. Comparing results from our survey vignettes to those of clinical practice from the Spanish Registry, 22 we observed the election of propranolol in a higher percentage of patients in our survey (28% vs 12%).…”

Section: Discussionmentioning

confidence: 52%

“…Some publications, with network meta‐analysis methodology, have indicated that some combinations could be superior to monotherapy 24 . However, given this theoretical basis, the use of combined IH treatment in Spain is rare 22 …”

Section: Discussionmentioning

confidence: 99%

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Inter‐ and intra‐observer variability in the selection of therapy for infantile hemangiomas among pediatric dermatologists in Spain

Colmenero

Boz

Wittel

et al. 2022

Pediatric Dermatology

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Background: Guidelines and expert recommendations on infantile hemangiomas (IH) are aimed at increasing homogeneity in clinical decisions based on the risk of sequelae.Objective: The objective was to analyze the inter-and intra-observer agreement among pediatric dermatologists in the choice of treatment for IH.Methods: We performed a cross-sectional inter-rater and intra-rater agreement study within the Spanish infantile hemangioma registry. Twenty-seven pediatric dermatologists were invited to participate in a survey with 50 clinical vignettes randomly selected within the registry. Each vignette contained a picture of an infantile hemangioma with a clinical description. Raters chose therapy among observation, topical timolol, or oral propranolol. The same survey reordered was completed 1 month later to assess intra-rater agreement. Vignettes were stratified into hemangioma risk categories following the Spanish consensus on IH. The agreement was measured using kappa statistics appropriate for the type of data (Gwet's AC 1 coefficient and Gwet's paired t test).Results: Twenty-four dermatologists completed the survey. Vignettes represented 7.8% of the Spanish hemangioma registry. The inter-rater agreement on the treatment decision was fair (AC 1 = 0.39, 95% confidence interval [CI]: 0.30-0.47). When stratified by risk category, good agreement was reached for high-risk hemangiomas (AC 1 = 0.77, 95% CI: 0.51-1.00), whereas for intermediate-and low-risk categories, the agreement was only fair (AC 1 0.31, 95% CI: 0.16-0.46 and AC 1 = 0.38, 95% CI: 0.27-0.48, respectively). Propranolol was the main option for high-risk hemangiomas (86.4%), timolol for intermediate-risk (36.8%), and observation for low-risk ones (55.9%). The intrarater agreement was good. The inter-rater agreement between pediatric dermatologists on the treatment of IH is only fair. Variability was most significant with intermediate-and low-risk hemangiomas.

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Section: Discussionmentioning

confidence: 52%