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Gong AJ, Garg T, Khalil A, Gowda PC, Mathai SC, Rowan NR, Merlo CA, Weiss CR. Health-Related Quality of Life Outcome Measures in Individuals With Hereditary Hemorrhagic Telangiectasia: A Scoping Review. Am J Rhinol Allergy 2024; 38:60-76. [PMID: 37855028 DOI: 10.1177/19458924231207123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Studies evaluating health-related quality of life (HRQOL) in patients with hereditary hemorrhagic telangiectasia (HHT) have expanded rapidly in the past decade. These studies have evaluated QOL aspects ranging from the general QOL for patients living with HHT to intervention-specific outcomes. However, few tools have been fully validated across the spectrum of disease manifestations and interventions in HHT. OBJECTIVE In this scoping review, we aim to map the literature on HHT-QOL metrics, identify gaps, inform future QOL research, and facilitate future metric development. METHODS We analyzed articles in English that assessed at least 1 measure of general HRQOL, including physical health, mental health, social health, or intervention-specific QOL in patients with HHT. Searches across 2 bibliographic databases (PubMed and Scopus) yielded 186 articles after duplicates were removed. Sixty-three studies met eligibility criteria: 22 prospective studies (34.9%), 20 retrospective studies (31.7%), 12 cross-sectional studies (17.5%), 6 randomized controlled trials or secondary analyses of a randomized controlled trials (9.5%), 2 qualitative studies (3.2%), and 1 case-control study (1.6%). Two additional studies-1 prospective and 1 cross-sectional study-were identified at the October 2022 14th International HHT Conference and included, making a total of 65 studies. RESULTS The 65 eligible studies used 30 QOL instruments. Twenty studies characterized baseline HRQOL, and 45 studies evaluated QOL before and after treatment. Of those 45 studies, 37 evaluated HRQOL before and after therapies targeting epistaxis and nasal symptoms, 4 targeted therapies for liver arteriovenous malformations and high-output heart failure, 3 evaluated therapies for both epistaxis and gastrointestinal bleeding, and 1 evaluated treatment targeting gastrointestinal bleeding alone. CONCLUSIONS Comparison of results across studies remains challenging given the heterogeneity in outcomes measures. Further development of HHT-specific patient-reported outcomes instruments that capture the global illness experience of HHT is needed.
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Affiliation(s)
- Anna J Gong
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tushar Garg
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adham Khalil
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Prateek C Gowda
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen C Mathai
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian A Merlo
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford R Weiss
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Perez Akly MS, Vazquez C, Besada CH, Rodriguez MJ, Conde MF, Cajal AR, Peuchot VA, Dardik D, Baccanelli MM, Serra MM. Prevalence of Intracranial Aneurysms in Hereditary Hemorrhagic Telangiectasia: Report from a Single Reference Center. AJNR Am J Neuroradiol 2022; 43:844-849. [PMID: 35589139 DOI: 10.3174/ajnr.a7505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/17/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Neurologic manifestations in hereditary hemorrhagic telangiectasia include an increased incidence of brain abscesses and ischemic strokes due to paradoxic embolization in addition to a wide spectrum of symptoms and complications due to typical brain vascular malformations. Intracranial aneurysms are not part of this brain vascular malformation spectrum. The aim of this study was to determine their prevalence in patients with hereditary hemorrhagic telangiectasia. MATERIALS AND METHODS This was a single-center, retrospective study. Adult patients from the institutional Hereditary Hemorrhagic Telangiectasia registry with a definitive diagnosis of hereditary hemorrhagic telangiectasia and an available report or angiographic imaging study were included and reviewed to determine the intracranial aneurysm prevalence. In addition, the morphologic characteristics of intracranial aneurysms and possible associated risk factors were collected. RESULTS Two hundred twenty-eight patients were analyzed. Thirty-seven aneurysms in 33 patients (14.5%; 95% CI, 9.9%-19%) were found. The median diameter of intracranial aneurysms was 3.2 mm (interquartile range, 2.6-4.4 mm). No association between intracranial aneurysm and sex, age, or genetic background was noted. There were no subarachnoid hemorrhagic events due to intracranial aneurysm rupture. CONCLUSIONS Due to the high prevalence of intracranial aneurysms in adult patients with hereditary hemorrhagic telangiectasia, further studies regarding bleeding risks and monitoring should be addressed.
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Affiliation(s)
- M S Perez Akly
- From the Department of Radiology (M.S.P.A., C.H.B., M.J.R., C.M.F.), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Hereditary Hemorrhagic Telangiectasia Unit (M.S.P.A., C.H.B., A.R.C., M.M.B., M.M.S.) Hospital Italiano, Buenos Aires, Argentina
| | - C Vazquez
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Department of Internal Medicine (C.V., M.M.S.), Hospital Italiano, Buenos Aires, Argentina
| | - C H Besada
- From the Department of Radiology (M.S.P.A., C.H.B., M.J.R., C.M.F.), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Hereditary Hemorrhagic Telangiectasia Unit (M.S.P.A., C.H.B., A.R.C., M.M.B., M.M.S.) Hospital Italiano, Buenos Aires, Argentina
| | - M J Rodriguez
- From the Department of Radiology (M.S.P.A., C.H.B., M.J.R., C.M.F.), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M F Conde
- From the Department of Radiology (M.S.P.A., C.H.B., M.J.R., C.M.F.), Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A R Cajal
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Hereditary Hemorrhagic Telangiectasia Unit (M.S.P.A., C.H.B., A.R.C., M.M.B., M.M.S.) Hospital Italiano, Buenos Aires, Argentina
- Translational Medicine and Biomedical Engineering Institute (A.R.C.), Buenos Aires, Argentina
- University Institute (A.R.C., M.M.B., M.M.S.), Hospital Italiano, Buenos Aires, Argentina
| | - V A Peuchot
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Internal Medicine Research Area (V.A.P.), Hospital Italiano, Buenos Aires, Argentina
| | - D Dardik
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- From the Department of Radiology (D.D.), Clínica Instituto de Diagnóstico Sociedad Anónima (INDISA), Santiago, Chile
| | - M M Baccanelli
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Department of Neurosurgery (M.M.B.), Hospital Italiano, Buenos Aires, Argentina
- Hereditary Hemorrhagic Telangiectasia Unit (M.S.P.A., C.H.B., A.R.C., M.M.B., M.M.S.) Hospital Italiano, Buenos Aires, Argentina
- University Institute (A.R.C., M.M.B., M.M.S.), Hospital Italiano, Buenos Aires, Argentina
| | - M M Serra
- A.R.G. Argentine Rendu Study Group (M.S.P.A., C.V., C.H.B., A.R.C., VA.P., D.D., M.M.B., M.M.S.), Buenos Aires, Argentina
- Department of Internal Medicine (C.V., M.M.S.), Hospital Italiano, Buenos Aires, Argentina
- Hereditary Hemorrhagic Telangiectasia Unit (M.S.P.A., C.H.B., A.R.C., M.M.B., M.M.S.) Hospital Italiano, Buenos Aires, Argentina
- University Institute (A.R.C., M.M.B., M.M.S.), Hospital Italiano, Buenos Aires, Argentina
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