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Meta-Analysis
. 2018 Jun 1;154(6):661-669.
doi: 10.1001/jamadermatol.2018.0002.

Vascular Malformations and Health-Related Quality of Life: A Systematic Review and Meta-analysis

Henry L Nguyen  1 , George F Bonadurer 3rd  1 , Megha M Tollefson  1
Affiliations
Meta-Analysis

Vascular Malformations and Health-Related Quality of Life: A Systematic Review and Meta-analysis

Henry L Nguyen et al. JAMA Dermatol. .

Abstract

Importance: Patients with vascular malformations (VAMs) and vascular overgrowth syndromes have lower health-related quality of life (HRQoL) attributable to social stigmatization, poor mental health, severity, and pain. However, the factors that contribute to this decreased HRQoL are not clear.

Objective: To perform a systematic review and meta-analysis of studies that used validated HRQoL instruments to compare the HRQoL of persons with VAMs with the US general population.

Data sources: A comprehensive search was performed in MEDLINE, Embase, PsycINFO, CINAHL, and Scopus from 1946 to March 31, 2017, with the consultation of an experienced librarian.

Study selection: All VAM studies with validated HRQoL instruments published in the English language were included. Case reports, review articles, non-English-language publications, and studies about the development of new HRQoL instruments were not included.

Data extraction and synthesis: Two reviewers assessed studies' eligibility and the risk of bias and performed data extraction. The meta-analysis was performed using the random-effects model. Comparisons of means were performed using the unpaired, 2-sample t test.

Main outcomes and measures: The outcome was HRQoL.

Results: Eleven studies met the inclusion criteria for a total of 692 patients with VAMs. Six studies (320 patients) were included in the meta-analysis, whereas 5 studies were included in the qualitative analysis (372 patients). Those with VAMs had lower 36-Item Short-Form Health Survey scores in bodily pain (mean difference, -11.87; 95% CI, -21.45 to -2.29; I2 = 92%; P = .02) and mental health (mean difference, -6.04; 95% CI, -11.55 to -0.52; I2 = 83%; P = .03) compared with the US general population.

Conclusions and relevance: Patients with VAMs had increased pain and psychosocial distress compared with the US general population. Pain and psychological morbidity are associated with poorer HRQoL and may serve as indicators for quality of life.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Flowchart of Search Methods
QoL indicates quality of life.
Figure 2.
Figure 2.. Meta-analysis of 6 Studies Comparing the 36-Item Short-Form Health Survey Domains of Physical Functioning, Role Physical, Bodily Pain, and General Health Against the US General Population
Bodily pain results are statistically significant. VM indicates venous malformation.
Figure 3.
Figure 3.. Meta-analysis of 6 Studies Comparing the 36-Item Short-Form Health Survey Domains of Vitality, Social Functioning, Role Emotional, and Mental Health Against the US General Population
Mental health results are statistically significant. VM indicates venous malformation.
See this image and copyright information in PMC

Comment in

  • Quality of Life and the Dermatologist.
    Council ML. Council ML. JAMA Dermatol. 2018 Jun 1;154(6):654-655. doi: 10.1001/jamadermatol.2018.0001. JAMA Dermatol. 2018. PMID: 29562056 No abstract available.

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