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Assessment of atopic dermatitis using self‐report and caregiver report: a multicentre validation study
Author(s) -
Silverberg J.I.,
Patel N.,
Immaneni S.,
Rusniak B.,
Silverberg N.B.,
Debashis R.,
Fewkes N.,
Simpson E.L.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14031
Subject(s) - medicine , atopic dermatitis , confidence interval , dermatology , predictive value , epidemiology , population , family history , pediatrics , environmental health
Summary Background The epidemiology of atopic dermatitis ( AD ) in the U.S.A. has been described largely via US population‐based questionnaire studies. However, the validity of the questions used for self‐ and caregiver‐reported eczema has not been previously demonstrated. Objectives To validate the assessment of self‐ and caregiver‐reported eczema. Methods We performed a prospective multicentre dermatology‐practice‐based study (three sites) to determine the validity of caregiver‐ and self‐reported ever having eczema and 1‐year history of eczema. Questionnaires were administered to unselected patients prior to their encounter. Patients ( n = 782) were then evaluated by expert dermatologists trained in utilizing the Hanifin and Rajka criteria for AD . Sensitivity, specificity, positive predictive value ( PPV ) and negative predictive value were determined. Results Caregiver‐reported 1‐year history of childhood eczema was found to have a sensitivity (95% confidence interval) of 0·70 (0·59–0·80), specificity of 0·96 (0·93–0·99) and PPV of 0·87 (0·78–0·96) when compared with a physician's diagnosis of AD at that visit. Similarly, self‐reported 1‐year history of adult eczema was found to have a sensitivity of 0·70 (0·59–0·80), specificity of 0·95 (0·93–0·97) and PPV of 0·76 (0·64–0·85). The specificities and PPV s of a history of ever having caregiver‐ (0·89, 0·82–0·96 and 0·81, 0·70–0·93) and self‐reported eczema (0·97, 0·95–0·99 and 0·91, 0·85–0·97) were high, with a high sensitivity in children (0·83, 0·72–0·95) but not in adults (0·43, 0·37–0·51). Conclusions Self‐ and caregiver‐reported diagnosis of eczema ever or in the past year based on a single question demonstrates sufficient validity for the epidemiological study of AD .