Assessment of atopic dermatitis using self-report and caregiver report: A multicentre validation study

J. I. Silverberg, N. Patel, S. Immaneni, B. Rusniak, N. B. Silverberg, R. Debashis, N. Fewkes, Eric Simpson

Research output: Contribution to journalArticle

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Abstract

Background The epidemiology of atopic dermatitis (AD) in the U.S.A. has been described largely via US population-based questionnaire studies. However, the validity of the questions used for self- and caregiver-reported eczema has not been previously demonstrated. Objectives To validate the assessment of self- and caregiver-reported eczema. Methods We performed a prospective multicentre dermatology-practice-based study (three sites) to determine the validity of caregiver- and self-reported ever having eczema and 1-year history of eczema. Questionnaires were administered to unselected patients prior to their encounter. Patients (n = 782) were then evaluated by expert dermatologists trained in utilizing the Hanifin and Rajka criteria for AD. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were determined. Results Caregiver-reported 1-year history of childhood eczema was found to have a sensitivity (95% confidence interval) of 0·70 (0·59-0·80), specificity of 0·96 (0·93-0·99) and PPV of 0·87 (0·78-0·96) when compared with a physician's diagnosis of AD at that visit. Similarly, self-reported 1-year history of adult eczema was found to have a sensitivity of 0·70 (0·59-0·80), specificity of 0·95 (0·93-0·97) and PPV of 0·76 (0·64-0·85). The specificities and PPVs of a history of ever having caregiver- (0·89, 0·82-0·96 and 0·81, 0·70-0·93) and self-reported eczema (0·97, 0·95-0·99 and 0·91, 0·85-0·97) were high, with a high sensitivity in children (0·83, 0·72-0·95) but not in adults (0·43, 0·37-0·51). Conclusions Self- and caregiver-reported diagnosis of eczema ever or in the past year based on a single question demonstrates sufficient validity for the epidemiological study of AD.

Original languageEnglish (US)
Pages (from-to)1400-1404
Number of pages5
JournalBritish Journal of Dermatology
Volume173
Issue number6
DOIs
StatePublished - Dec 1 2015

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Validation Studies
Eczema
Atopic Dermatitis
Self Report
Caregivers
Multicenter Studies
Dermatology
Epidemiologic Studies
Epidemiology
Confidence Intervals
Physicians
Sensitivity and Specificity
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Dermatology

Cite this

Assessment of atopic dermatitis using self-report and caregiver report : A multicentre validation study. / Silverberg, J. I.; Patel, N.; Immaneni, S.; Rusniak, B.; Silverberg, N. B.; Debashis, R.; Fewkes, N.; Simpson, Eric.

In: British Journal of Dermatology, Vol. 173, No. 6, 01.12.2015, p. 1400-1404.

Research output: Contribution to journalArticle

Silverberg, JI, Patel, N, Immaneni, S, Rusniak, B, Silverberg, NB, Debashis, R, Fewkes, N & Simpson, E 2015, 'Assessment of atopic dermatitis using self-report and caregiver report: A multicentre validation study', British Journal of Dermatology, vol. 173, no. 6, pp. 1400-1404. https://doi.org/10.1111/bjd.14031
Silverberg JI, Patel N, Immaneni S, Rusniak B, Silverberg NB, Debashis R et al. Assessment of atopic dermatitis using self-report and caregiver report: A multicentre validation study. British Journal of Dermatology. 2015 Dec 1;173(6):1400-1404. https://doi.org/10.1111/bjd.14031
Silverberg, J. I. ; Patel, N. ; Immaneni, S. ; Rusniak, B. ; Silverberg, N. B. ; Debashis, R. ; Fewkes, N. ; Simpson, Eric. / Assessment of atopic dermatitis using self-report and caregiver report : A multicentre validation study. In: British Journal of Dermatology. 2015 ; Vol. 173, No. 6. pp. 1400-1404.
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abstract = "Background The epidemiology of atopic dermatitis (AD) in the U.S.A. has been described largely via US population-based questionnaire studies. However, the validity of the questions used for self- and caregiver-reported eczema has not been previously demonstrated. Objectives To validate the assessment of self- and caregiver-reported eczema. Methods We performed a prospective multicentre dermatology-practice-based study (three sites) to determine the validity of caregiver- and self-reported ever having eczema and 1-year history of eczema. Questionnaires were administered to unselected patients prior to their encounter. Patients (n = 782) were then evaluated by expert dermatologists trained in utilizing the Hanifin and Rajka criteria for AD. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were determined. Results Caregiver-reported 1-year history of childhood eczema was found to have a sensitivity (95{\%} confidence interval) of 0·70 (0·59-0·80), specificity of 0·96 (0·93-0·99) and PPV of 0·87 (0·78-0·96) when compared with a physician's diagnosis of AD at that visit. Similarly, self-reported 1-year history of adult eczema was found to have a sensitivity of 0·70 (0·59-0·80), specificity of 0·95 (0·93-0·97) and PPV of 0·76 (0·64-0·85). The specificities and PPVs of a history of ever having caregiver- (0·89, 0·82-0·96 and 0·81, 0·70-0·93) and self-reported eczema (0·97, 0·95-0·99 and 0·91, 0·85-0·97) were high, with a high sensitivity in children (0·83, 0·72-0·95) but not in adults (0·43, 0·37-0·51). Conclusions Self- and caregiver-reported diagnosis of eczema ever or in the past year based on a single question demonstrates sufficient validity for the epidemiological study of AD.",
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T2 - A multicentre validation study

AU - Silverberg, J. I.

AU - Patel, N.

AU - Immaneni, S.

AU - Rusniak, B.

AU - Silverberg, N. B.

AU - Debashis, R.

AU - Fewkes, N.

AU - Simpson, Eric

PY - 2015/12/1

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N2 - Background The epidemiology of atopic dermatitis (AD) in the U.S.A. has been described largely via US population-based questionnaire studies. However, the validity of the questions used for self- and caregiver-reported eczema has not been previously demonstrated. Objectives To validate the assessment of self- and caregiver-reported eczema. Methods We performed a prospective multicentre dermatology-practice-based study (three sites) to determine the validity of caregiver- and self-reported ever having eczema and 1-year history of eczema. Questionnaires were administered to unselected patients prior to their encounter. Patients (n = 782) were then evaluated by expert dermatologists trained in utilizing the Hanifin and Rajka criteria for AD. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were determined. Results Caregiver-reported 1-year history of childhood eczema was found to have a sensitivity (95% confidence interval) of 0·70 (0·59-0·80), specificity of 0·96 (0·93-0·99) and PPV of 0·87 (0·78-0·96) when compared with a physician's diagnosis of AD at that visit. Similarly, self-reported 1-year history of adult eczema was found to have a sensitivity of 0·70 (0·59-0·80), specificity of 0·95 (0·93-0·97) and PPV of 0·76 (0·64-0·85). The specificities and PPVs of a history of ever having caregiver- (0·89, 0·82-0·96 and 0·81, 0·70-0·93) and self-reported eczema (0·97, 0·95-0·99 and 0·91, 0·85-0·97) were high, with a high sensitivity in children (0·83, 0·72-0·95) but not in adults (0·43, 0·37-0·51). Conclusions Self- and caregiver-reported diagnosis of eczema ever or in the past year based on a single question demonstrates sufficient validity for the epidemiological study of AD.

AB - Background The epidemiology of atopic dermatitis (AD) in the U.S.A. has been described largely via US population-based questionnaire studies. However, the validity of the questions used for self- and caregiver-reported eczema has not been previously demonstrated. Objectives To validate the assessment of self- and caregiver-reported eczema. Methods We performed a prospective multicentre dermatology-practice-based study (three sites) to determine the validity of caregiver- and self-reported ever having eczema and 1-year history of eczema. Questionnaires were administered to unselected patients prior to their encounter. Patients (n = 782) were then evaluated by expert dermatologists trained in utilizing the Hanifin and Rajka criteria for AD. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were determined. Results Caregiver-reported 1-year history of childhood eczema was found to have a sensitivity (95% confidence interval) of 0·70 (0·59-0·80), specificity of 0·96 (0·93-0·99) and PPV of 0·87 (0·78-0·96) when compared with a physician's diagnosis of AD at that visit. Similarly, self-reported 1-year history of adult eczema was found to have a sensitivity of 0·70 (0·59-0·80), specificity of 0·95 (0·93-0·97) and PPV of 0·76 (0·64-0·85). The specificities and PPVs of a history of ever having caregiver- (0·89, 0·82-0·96 and 0·81, 0·70-0·93) and self-reported eczema (0·97, 0·95-0·99 and 0·91, 0·85-0·97) were high, with a high sensitivity in children (0·83, 0·72-0·95) but not in adults (0·43, 0·37-0·51). Conclusions Self- and caregiver-reported diagnosis of eczema ever or in the past year based on a single question demonstrates sufficient validity for the epidemiological study of AD.

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