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Expert Survey Tracks Vascular Malformation Genetic Test Hurdles

A team from the Children's Hospital of Philadelphia, Cincinnati Children's Hospital Medical Center, and other centers considers factors preventing vascular malformation (VM)-affected patients and families from obtaining genetic testing, highlighting concerns over everything from murky requirements to a lack of clinician education and administrative support. As they report in JAMA Network Open, the researchers sent electronic surveys and email follow-up to experts at 81 vascular anomaly centers, focusing on Pediatric Hematology-Oncology Vascular Anomalies Interest Group members. Based on responses from 55 experts, including 50 pediatric hematologist-oncologists, the authors got a look at vascular malformation test ordering responsibilities and patterns, rates of in-house testing, and responsibilities for obtaining prior authorization and dealing with insurance denials within teams at small, medium, and large centers from early March 2022 to Sept. 30 of that year. Overall, survey results suggested that the "effort to obtain genetic testing for VM, compared with patients with cancer, was perceived as excessive, despite genetic testing being considered standard of care for this population," they report, noting that the current study presents "multiple interventions to support clinicians ordering genetic testing for VM."