3.8 Article

Towards a better treatment of patients with vascular malformations: certified interdisciplinary centers are mandatory*

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ELSEVIER GMBH
DOI: 10.1016/j.zefq.2021.11.003

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Orphan disease; Evidence-based medicine; Certification; Vascular anomalies; Classification

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This article discusses the importance of vascular anomalies as orphan diseases and highlights the necessity of multidisciplinary treatment centers for patient care. The authors recommend establishing a set of quality indicators and standards to improve healthcare in Germany.
Background: Vascular anomalies are orphan diseases that occur in all age groups and range from purely aesthetic to potentially life-threatening conditions. This thesis paper outlines the typical conferring problems in patient management and possible structural solutions for a better patient treatment in the future. Methods: A multi-perspective author panel consisting of key stakeholders from the German Interdisciplinary Society of Vascular Anomalies and the German Society for Surgery defined problem areas and possible solutions including quality indicators as criteria for certified interdisciplinary Vascular Anomalies Centers (VAC). Results: According to the literature available, clearly defined nomenclature and nosological entities often remain unused in this field, and consented diagnostic and therapeutic evidence is rare. Expert opinions dominate and in some cases lead to disparate recommendations. Typical patient problems arise from this situation, exemplified in patient vignettes. Centralized and standardized patient treatment in interdisciplinary VAC may be a solution to this problem. These centers should agree on a set of general principles and quality indicators with an additional minimum set of structural and procedural criteria. Discussion: The present position paper outlines perspectives for implementing certified interdisciplinary VAC. There is a need for a comprehensive nomenclature, access to interdisciplinary treatment centers, more scientific evidence, and further education in this rare group of diseases. Conclusion: Use of scientifically sound and patient-relevant criteria for certifying the interdisciplinary quality of VAC is expected to improve health care in Germany.

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