儿童特应性皮炎的可靠评估的介绍：新的儿童特应性皮炎诊断标准
2016/07/28
摘要
目标：以问卷为基础的特应性皮炎（AD）的诊断标准已经被提出，用以发现有变异性皮炎的特异性皮炎（AD）的主要组别。我们旨在开发新的、基于问卷调查的儿童特异性皮炎诊断标准，可以检测更全面的特异性皮炎，包括非变异性型。
方法：准备了检测儿童期特异性皮炎的问卷调查的草案版本，用于初步的医院-（n = 1756）和以社区为基础的（n = 1320）调查。从分析中提出儿童特应性皮炎的可靠评估（REACH），并且在以社区为基础调查的推导（n = 1129）和验证（n = 1191）单元得到了证实。
结果：儿童特应性皮炎的可靠评估（REACH）由11个问题组成，包括2个主要标准和9个次要标准。特应性皮炎（AD）被诊断为“肘前或窝湿疹”的主要组来完成2大主要标准（2M）问卷调查，“非肘前或窝湿疹”的次要组来完成1个主要标准加4个或更多的次要标准湿疹（1M +4m）问卷调查。在验证组中，REACH预测出的特应性皮炎患病1年的患病率估计为12.3%（95%可信区间，10.5% - 14.2%），灵敏度为75.2%，特异性为96.1%，错误率为6.4%。REACH在错误分类的数量上表现出了比ISAAC更好的诊断性能（10%）。
结论：我们建议儿童特应性皮炎的可靠评估（REACH）作为新的、全的、基于问卷的标准，用于儿童特应性皮炎流行病学调查。需要进行进一步的研究来验证在不同的人群或国家大规模的流行病学调查的背景下，REACH的有效性。
（杨冬 审校）
Allergy Asthma ImmunolRes. 2016 May;8(3):230-8.doi: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 SC1, Bae JM2, Lee HJ3, Kim HJ4, Kim BS5, Li K6, Cho JW7, Park CO8, Cho SH2, Lee KH8, Kim DW9, Park CW10, Kim KH11; Korean Atopic Dermatitis Association's Atopic Dermatitis Criteria Group.
Author information
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.
KEYWORDS:Atopic dermatitis; REACH; diagnostic criteria; questionnaire
Allergy Asthma ImmunolRes. 2016 May;8(3):230-8.doi:10.4168/aair.2016.8.3.230.
