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- Title
Diagnosing atopic dermatitis in infancy: Questionnaire reports vs criteria-based assessment.
- Authors
Dharma, Christoffer; Lefebvre, Diana L.; Tran, Maxwell M.; Lu, Zihang; Lou, Wendy Y. W.; Subbarao, Padmaja; Becker, Allan B.; Mandhane, Piush J.; Turvey, Stuart E.; Moraes, Theo J.; Azad, Meghan B.; Sears, Malcolm R.; Anand, SS; Befus, AD; Brauer, M; Brook, JR; Chen, E; Cyr, MM; Daley, D; Dell, SD
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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).
- Subjects
CANADA; ATOPIC dermatitis; ALLERGIES; ASTHMA; CONTACT dermatitis; FOOD allergy; ATOPIC dermatitis treatment; ALGORITHMS; COMPARATIVE studies; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; QUESTIONNAIRES; RESEARCH; RESEARCH funding; RISK assessment; EVALUATION research; DISEASE prevalence; RECEIVER operating characteristic curves; DIAGNOSIS
- Publication
Paediatric & Perinatal Epidemiology, 2018, Vol 32, Issue 6, p556
- ISSN
0269-5022
- Publication type
journal article
- DOI
10.1111/ppe.12525