Validation of a Parent-Reported Diagnostic Instrument in a U.S. Referral Population: The Childhood Eczema Questionnaire

Background/Objectives: There is a paucity of validated tools for diagnosing atopic dermatitis (AD) in very young children that do not rely on clinical evaluation. The Childhood Eczema Questionnaire (CEQ)—a diagnostic tool for AD in children younger than 2 years that a caretaker can complete—was recently validated in Sweden. The objective of this study was to validate the tool in a U.S. population. As a substudy, we added an additional question that was independently assessed. Methods: Children younger than 2 years old were recruited from a dermatology clinic. Their caretakers completed a questionnaire containing the original tool's three questions as well as a fourth question that increased the time frame measured from 1 week to 6 months. Questionnaires with all “yes” answers were considered positive and were compared with a dermatologist diagnosis of AD. Results: A total of 283 subjects were recruited. The first three questions (the original CEQ) predicted a positive diagnosis of AD with a sensitivity of 0.72 (95% confidence interval [CI] 0.58, 0.82) and a specificity of 0.93 (95% CI 0.87, 0.95). In a separate analysis we included the first two questions and the fourth question and found that the sensitivity increased to 0.82 (95% CI 0.69, 0.90) with a specificity of 0.89 (95% CI 0.83, 0.93). Conclusion: This study validates a novel parental questionnaire for the diagnosis of AD in children younger than 2 years in a U.S. clinic population.