Diagnosing atopic dermatitis in infancy: Questionnaire reports vs criteria-based assessment
| Autor: | Allan B. Becker, Diana L. Lefebvre, Zihang Lu, Stuart E. Turvey, Maxwell M. Tran, Child Study Investigators, Christoffer Dharma, Piush J. Mandhane, Padmaja Subbarao, Theo J. Moraes, Malcolm R. Sears, Meghan B. Azad, Wendy Y. W. Lou |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Canada Allergy medicine.medical_specialty Epidemiology Risk Assessment Dermatitis Atopic Atopy 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Risk Factors Surveys and Questionnaires Health care Prevalence Humans Medicine Longitudinal Studies Asthma Receiver operating characteristic business.industry Infant Atopic dermatitis medicine.disease Rash 3. Good health ROC Curve 030228 respiratory system Child Preschool Family medicine Pediatrics Perinatology and Child Health Female medicine.symptom business Algorithms |
| Zdroj: | Paediatric and Perinatal Epidemiology. 32:556-567 |
| ISSN: | 0269-5022 |
| DOI: | 10.1111/ppe.12525 |
| Popis: | Background Persisting atopic dermatitis (AD) is known to be associated with more serious allergic diseases at later ages; however, making an accurate diagnosis during infancy is challenging. We assessed the diagnostic performance of questionnaire-based AD measures with criteria-based in-person clinical assessments at age 1 year and evaluated the ability of these diagnostic methods to predict asthma, allergic rhinitis and food allergies at age 5 years. Methods Data relate to 3014 children participating in the Canadian Healthy Infant Longitudinal Development (CHILD) Study who were directly observed in a clinical assessment by an experienced healthcare professional using the UK Working Party criteria. The majority (2221; 73.7%) of these children also provided multiple other methods of AD ascertainment: a parent reporting a characteristic rash on a questionnaire, a parent reporting the diagnosis provided by an external physician and a combination of these two reports. Results Relative to the direct clinical assessment, the area under the Receiver Operating Characteristic curve for a parental report of a characteristic rash, reported physician diagnosis and a combination of both were, respectively, 0.60, 0.69 and 0.70. The strongest predictor of asthma at 5 years was AD determined by criteria-based in-person clinical assessment followed by the combination of parental and physician report. Conclusions These findings suggest that questionnaire data cannot accurately substitute for assessment by experienced healthcare professionals using validated criteria for diagnosis of atopic dermatitis. Combining the parental report with diagnosis by a family physician might sometimes be appropriate (eg to avoid costs of a clinical assessment). |
| Databáze: | OpenAIRE |
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