1. 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
- Author
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Flohr, C., Weinmayr, G., Weiland, S. K., Addo-Yobo, E., Annesi-Maesano, Isabella, Björkstén, B., Bråbäck, L., Büchele, G., Chico, M., Cooper, P., Clausen, M., El Sharif, N., Martinez Gimeno, A., Mathur, R. S., von Mutius, E., Morales Suarez-Varela, M., Pearce, N., Svabe, V., Wong, G. W. K., Yu, M., Zhong, N. S., Williams, H. C., Renseigné, Non, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Geology, Ball State University, School of Biosciences [Cardiff], Cardiff University, Flohr C, G Weinmayr, M Clausen, El Sharif N, Martinez Gimeno A, RS Mathur, Mutius von E, Morales-Suarez Varela M, N Pearce, V Svabe, Wong GW, M Yu, SK Weiland, Zhong NS, Williams HC, Phase Deux Groupe d'étude ISAAC .G Büchele, Genuneit J, Kleiner A, G Nagel, Weinmayr G, Priftanji A, A Shkurti, Simenati J, E-Addo Yobo, E Grabocka, K Shyti, S Agolli, Gurakuqi A, RT Stein, de Pereira MU, MH Jones, PM Pitrez, Cooper PJ, YZ Chen, Annesi-Maesano I, C Lai, Wong G, MA Riikjärv, T Annus, M Gotua, M Rukhadze, T Abramidze, Kvachadze I, L Karsanidze, M Kiladze, B Bjorksten, N Dolidze, Leupold W, U Keil, von Mutius E, Arthur P, C Gratziou, C Priftis, Papadopoulou A, C Katsardis, Tsanakas J, L Bråbäck, E Hatziagorou, Kirvassilis F, JR Shah, RP Khubchandani, S Mantri, Forastière F, G Büchele, M Chico, and P Cooper
- Subjects
Male ,Allergy ,medicine.medical_specialty ,Eczema ,Physical examination ,Dermatology ,Severity of Illness Index ,Atopy ,030207 dermatology & venereal diseases ,03 medical and health sciences ,MESH: Physical Examination ,0302 clinical medicine ,Risk Factors ,immune system diseases ,MESH: Risk Factors ,Germany ,Surveys and Questionnaires ,MESH: Child ,MESH: Severity of Illness Index ,Epidemiology ,Prevalence ,otorhinolaryngologic diseases ,medicine ,Humans ,030212 general & internal medicine ,Child ,skin and connective tissue diseases ,Physical Examination ,MESH: Germany ,MESH: Prevalence ,Asthma ,Symptom prevalence ,MESH: Humans ,medicine.diagnostic_test ,business.industry ,MESH: Questionnaires ,Atopic dermatitis ,medicine.disease ,MESH: Male ,3. Good health ,Surgery ,El Niño ,MESH: Eczema ,Family medicine ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,MESH: Female - Abstract
International audience; BACKGROUND: 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.
- Published
- 2009