Identifying the best predictive diagnostic criteria for psoriasis in children (< 18 years): a UK multicentre case–control diagnostic accuracy study (DIPSOC study)*
| Autor: | Nigel Burrows, C. Jury, J.E. Gach, C. Wilkinson, J. Llewellyn, K. Kuet, A. Abdul-Wahab, S.M. Taibjee, S. Gran, Kim S Thomas, S. Darne, Ruth Murphy, E. Burden-Teh, Anthony Bewley, Tamar Nijsten, Jane Ravenscroft, T McPherson, R. Katugampola, Carolyn Hughes |
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| Přispěvatelé: | Dermatology, Burden-Teh, E [0000-0002-0033-2836], Gran, S [0000-0002-2443-5100], Nijsten, T [0000-0001-9940-2875], Abdul-Wahab, A [0000-0002-1474-0398], Bewley, A [0000-0003-1195-0290], Burrows, N [0000-0002-1090-8261], Darne, S [0000-0002-6155-7772], Gach, JE [0000-0002-0333-7165], McPherson, T [0000-0001-9215-0302], Ravenscroft, JC [0000-0002-1609-7084], Taibjee, S [0000-0003-2433-5481], Thomas, KS [0000-0001-7785-7465], Apollo - University of Cambridge Repository |
| Jazyk: | angličtina |
| Předmět: |
Adult
medicine.medical_specialty Meatus Erythema business.industry Area under the curve Diagnostic accuracy Dermatology medicine.disease United Kingdom medicine.anatomical_structure Psoriasis Scalp Area Under Curve Case-Control Studies Erythematous plaque medicine Humans Family history medicine.symptom business Child Medical History Taking |
| Zdroj: | British Journal of Dermatology, 186(2), 341-351. Wiley-Blackwell Publishing Ltd |
| ISSN: | 0007-0963 1365-2133 |
| Popis: | Background: In children, psoriasis can be challenging to diagnose. Difficulties arise from differences in the clinical presentation compared with adults. Objectives: To test the diagnostic accuracy of previously agreed consensus criteria and to develop a shortlist of the best predictive diagnostic criteria for childhood psoriasis. Methods: A case–control diagnostic accuracy study in 12 UK dermatology departments (2017–2019) assessed 18 clinical criteria using blinded trained investigators. Children (< 18 years) with dermatologist-diagnosed psoriasis (cases, N = 170) or a different scaly inflammatory rash (controls, N = 160) were recruited. The best predictive criteria were identified using backward logistic regression, and internal validation was conducted using bootstrapping. Results: The sensitivity of the consensus-agreed criteria and consensus scoring algorithm was 84·6%, the specificity was 65·1% and the area under the curve (AUC) was 0·75. The seven diagnostic criteria that performed best were: (i) scale and erythema in the scalp involving the hairline, (ii) scaly erythema inside the external auditory meatus, (iii) persistent well-demarcated erythematous rash anywhere on the body, (iv) persistent erythema in the umbilicus, (v) scaly erythematous plaques on the extensor surfaces of the elbows and/or knees, (vi) well-demarcated erythematous rash in the napkin area involving the crural fold and (vii) family history of psoriasis. The sensitivity of the best predictive model was 76·8%, with specificity 72·7% and AUC 0·84. The c-statistic optimism-adjusted shrinkage factor was 0·012. Conclusions: This study provides examination- and history-based data on the clinical features of psoriasis in children and proposes seven diagnostic criteria with good discriminatory ability in secondary-care patients. External validation is now needed. |
| Databáze: | OpenAIRE |
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