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.

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RESEARCH PRODUCT

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 Isabella 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 N. S. Zhong H. C. Williams Non Renseigné

subject

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

description

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.

year	journal	country	edition	language
2009-10-01

10.1111/j.1365-2133.2009.09261.x https://hal.sorbonne-universite.fr/hal-00595887