Discordance Between Diagnosis Tools for Assessing Eczema in Infants: A Challenge for Intervention Trials.

Autor:	Pittet LF, Messina NL, Gardiner K, Freyne B, Abruzzo V; From the Infectious Diseases Group, Murdoch Children's Research Institute., Morrison C; From the Infectious Diseases Group, Murdoch Children's Research Institute., Vuillermin P, Allen KJ; Formerly Centre for Food and Allergy Research., Ponsonby AL, Robins-Browne R, Shann F; Department of Paediatrics, The University of Melbourne., Flanagan KL, Donath S, Casalaz D; Neonatal Intensive Care Unit, Mercy Hospital for Women, Heidelberg., Phillips R, Curtis N
Jazyk:	angličtina
Zdroj:	Dermatitis : contact, atopic, occupational, drug [Dermatitis] 2022 May-Jun 01; Vol. 33 (3), pp. 207-214. Date of Electronic Publication: 2022 Feb 16.
DOI:	10.1097/DER.0000000000000842
Abstrakt:	Background: There is no standardized definition for infant eczema, and various tools have been used across studies, precluding direct comparison. Objective: The aim of the study was to assess and to compare the accuracy of diagnostic tools for infant eczema using the extensive data collected in Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR), an eczema prevention trial. Methods: Eczema incidence was assessed by 3 questionnaire-based measures: modified UK diagnostic tool, parent-reported medically diagnosed eczema, and parent-reported use of topical corticosteroids. Agreement between the definitions was quantified using κ coefficient. Eczema severity was assessed by 3-monthly Patient-Oriented Eczema Measure (POEM) scores and a SCORing Atopic Dermatitis (SCORAD) clinical assessment at a 12-month visit (ClinicalTrial.gov: NCT01906853). Results: Among the 538 participants fulfilling at least 1 of the 3 questionnaire-based eczema definitions, only 197 participants (37%) met all 3 definitions. Agreement between the definitions was poor with κ coefficients ranging from -0.11 to 0.62. The most frequently reported symptoms were generally dry skin (483/538, 90%) and pruritus (400/538, 74%). The face (352/538, 65%) and the trunk (306/538, 57%) were more frequently affected than the creases (257/538, 48%). Participants fulfilling all 3 questionnaire-based definitions of eczema were more likely to have higher severity scores and earlier onset of symptoms. Conclusions: There is poor agreement between currently available tools for assessing infant eczema. Competing Interests: The authors have no funding or conflicts of interest to declare. (Copyright © 2022 American Contact Dermatitis Society. All Rights Reserved.)
Databáze:	MEDLINE
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