How well do questionnaires perform compared with physical examination in detecting flexural eczema? Findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two

C. Flohr;G. Weinmayr;S. K. Weiland;E. Addo-Yobo;I. Annesi-Maesano;B. Björkstén;L. Bråbäck;G. Büchele;M. Chico;P. Cooper;M. Clausen;N. El Sharif;A. Martinez Gimeno;R. S. Mathur;E. von Mutius;M. Morales Suarez-Varela;N. Pearce;V. Svabe;G. W.K. Wong;M. Yu;南山钟;H. C. Williams;G. Büchele;J. Genuneit;A. Kleiner;G. Nagel;G. Weinmayr;A. Priftanji;A. Shkurti;J. Simenati;E. Grabocka;K. Shyti;S. Agolli;A. Gurakuqi;R. T. Stein;M. Urrutia de Pereira;M. H. Jones;P. M. Pitrez;P. J. Cooper;M. Chico;Y. Z. Chen;N. S. Zhong;C. Lai;G. Wong;M. A. Riikjärv;T. Annus;I. Annesi-Maesano;M. Gotua;M. Rukhadze;T. Abramidze;I. Kvachadze;L. Karsanidze;M. Kiladze;N. Dolidze;W. Leupold;U. Keil;E. von Mutius;S. K. Weiland;E. von Mutius;U. Keil;S. K. Weiland;P. Arthur;E. Addo-Yobo;C. Gratziou;C. Priftis;A. Papadopoulou;C. Katsardis;J. Tsanakas;E. Hatziagorou;F. Kirvassilis;M. Clausen;J. R. Shah;R. S. Mathur;R. P. Khubchandani;S. Mantri;F. Forastiere;R. Di Domenicantonio;M. De Sario;S. Sammarro;R. Pistelli;M. G. Serra;G. Corbo;C. A. Perucci;V. Svabe;D. Sebre;G. Casno;I. Novikova;L. Bagrade;B. Brunekreef;D. Schram;G. Doekes;P. H.N. Jansen-Van Vliet;N. A.H. Janssen;F. J.H. Aarts;G. de Meer;J. Crane;K. Wickens;D. Barry;W. Nystad;R. Bolle;E. Lund;N. El-Sharif;B. Nemery;F. Barghuthy;S. Abu Huij;M. Qlebo;J. Batlles Garrido;T. Rubi Ruiz;A. Bonillo Perales;Y. Gonzalez Jiménez;J. Aguirre Rodriguez;J. Momblan de Cabo;A. Losilla Maldonado;M. Daza Torres;L. Garcia-Marcos;A. Martinez Torres;J. J.Guillén Pérez;A. Piñana López;S. Castejon Robles;G. Garcia Hernandez;A. Martinez Gimeno;A. L.Moro Rodríguez;C. Luna Paredes;I. Gonzalez Gil;M. M.Morales Suarez-Varela;A. Llopis González;A. Escribano Montaner;M. Tallon Guerola;L. Bråbäck;M. Kjellman;L. Nilsson;X. M. Mai;L. Bråbäck;A. Sandin;Y. Saraçlar;S. Kuyucu;A. Tuncer;C. Saçkesen;V. Sumbuloğlu;P. Geyik;C. Kocabaş;D. Strachan;B. Kaur;N. Aït-Khaled;H. R. Anderson;M. I. Asher;R. Beasley;B. Björkstén;B. Brunekreef;J. Crane;P. Ellwood;C. Flohr;S. Foliaki;F. Forastiere;L. García-Marcos;U. Keil;C. Lai;J. Mallol;E. Mitchell;S. Montefort;E. von Mutius;J. Odhiambo;N. Pearce;C. Robertson;A. Stewart;D. Strachan;S. K. Weiland;G. Weinmayr;H. Williams;G. Wong

University of Nottingham;Ulm University;Kwame Nkrumah University of Science and Technology;Institut national de la santé et de la recherche médicale;Karolinska Institutet;Sundsvall Hospital;Universidad San Francisco de Quito;Landspitali University Hospital;Al-Quds University;‘12 de Octubre’ University Children’s Hospital;Jaslok Hospital and Research Centre;Ludwig Maximilian University of Munich;University of Valencia;Massey University;Riga Stradins University;Chinese University of Hong Kong;Capital Institute of Pediatrics;Guangzhou Medical College;Uruguaiana;Pichincha Province;Kintampo;Hawkes Bay;Ramallah;West Sussex;London

发表时间：2009-10-1

期刊：British Journal of Dermatology

语言：English

摘要

SummaryBackground Questionnaires are widely used in epidemiological studies to measure eczema symptom prevalence, but there are concerns regarding their accuracy if used as a diagnostic tool. Objectives To compare the performance of a validated eczema symptom questionnaire and a standardized skin examination protocol employed in the second phase of the International Study of Asthma and Allergies in Childhood (ISAAC). Methods A total of 30 358 schoolchildren aged 8-12 years from 18 countries were examined for flexural eczema. Parents also completed an eczema symptom questionnaire. We compared prevalence estimates at the population level based on the questionnaire vs. physical examination. We also compared the skin examination and the ISAAC questionnaire in making a diagnosis of flexural eczema. Results The point prevalences for flexural eczema at centre level based on a single examination were lower than the questionnaire-based 12-month period prevalences (mean centre prevalence 3·9% vs. 9·4%). Correlation between prevalences of both outcome measures was high (r = 0·77, P < 0·001). At the individual level, questionnaire-derived symptoms of 'persistent flexural eczema in the past 12 months' missed < 10% of cases of flexural eczema detected on physical examination. However, between 33% and 100% of questionnaire-based symptoms of 'persistent flexural eczema in the past 12 months' were not confirmed on examination. Conclusions ISAAC questionnaire-derived symptom prevalences are sufficiently precise for comparisons between populations. Where diagnostic precision at the individual level is important, questionnaires should be validated and potentially modified in those populations beforehand, or a standardized skin examination protocol should be used.

关键词

Atopic dermatitis

Atopic eczema

Diagnostic criteria

Epidemiology

文献指纹

医学与生命科学

Eczema

Physical Examination

Hypersensitivity

Asthma

Skin

Population

Epidemiologic Studies

Outcome Assessment (Health Care)

期刊度量

Scopus度量

年份	CiteScore	SJR	SNIP
1996
1997
1998
1999		0.927	1.587
2000		1.037	1.532
2001		1.142	1.505
2002		1.248	1.636
2003		1.274	1.851
2004		1.306	1.69
2005		1.294	1.79
2006		1.304	1.667
2007		1.513	1.776
2008		1.588	1.715
2009		2.038	1.985
2010		2.187	1.933
2011	7.3	1.932	1.906
2012	7	2.064	1.779
2013	7.3	1.999	1.955
2014	7.8	2.072	1.991
2015	8.4	2.133	1.94
2016	8.3	2.07	1.909
2017	8.3	2.166	1.886
2018	9.2	1.984	1.787
2019	9.8	2.08	2.113
2020	11.3
2021