Allergy Asthma Immunol Res.  2016 May;8(3):230-238. 10.4168/aair.2016.8.3.230.

Introduction of the Reliable Estimation of Atopic Dermatitis in ChildHood: Novel, Diagnostic Criteria for Childhood Atopic Dermatitis

• Lee SC
• Bae JM
• Lee HJ
• Kim HJ
• Kim BS
• Li K
• Cho JW
• Park CO
• Cho SH
• Lee KH
• Kim DW
• Park CW
• Kim KH
• The Korean Atopic Dermatitis Association's Atopic Dermatitis Criteria Group

• KMID: 2391043
• DOI: http://doi.org/10.4168/aair.2016.8.3.230

Abstract

PURPOSE
Questionnaire-based diagnostic criteria for atopic dermatitis (AD) have been proposed to detect the major group of AD with flexural dermatitis. We aimed to develop novel, questionnaire-based diagnostic criteria for childhood AD, which can detect more comprehensive AD including non-flexural type.
METHODS
The draft version of questionnaire to detect childhood AD was prepared to be used for preliminary hospital- (n=1,756) and community-based (n=1,320) surveys. From analysis, the Reliable Estimation of Atopic dermatitis of ChildHood (REACH) was derived and verified in derivation (n=1,129) and validation (n=1,191) sets by community-based surveys.
RESULTS
The REACH consists of 11 questions including 2 major and 9 minor criteria. AD is diagnosed as the major group of 'eczema on the antecubital or popliteal fossa' to fulfill the 2 major criteria (2M), and the minor group of 'eczema on the non-antecubital or popliteal fossa' to fulfill the 1 major plus 4 or more minor criteria (1M+4m). In the validation set, the overall 1-year AD prevalence by the REACH was estimated as 12.3% (95% CI, 10.5%-14.2%), and the REACH showed a sensitivity of 75.2%, a specificity of 96.1%, and an error rate of 6.4%. The REACH demonstrated better diagnostic performance than the ISAAC in terms of the number of misclassification (10.0%).
CONCLUSIONS
We propose the REACH as new full, questionnaire-based diagnostic criteria for childhood AD in epidemiological surveys. Further studies are warranted to validate the REACH in different populations or countries in the context of large-scale, epidemiological surveys.

Keyword

Atopic dermatitis; diagnostic criteria; REACH; questionnnaire

MeSH Terms

Dermatitis
Dermatitis, Atopic*
Prevalence
Sensitivity and Specificity

Figure

• 

  Figure Flow chart to develop the REACH as new diagnostic criteria for childhood AD.

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