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, I. 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. YuN. S. Zhong, H. C. Williams, G. Büchele, J. Genuneit, A. Kleiner, G. Nagel, G. Weinmayr, A. Priftanji, A. Shkurti, J. Simenati, E. Grabocka, K. Shyti, S. Agolli, A. Gurakuqi, R. T. Stein, M. Urrutia de Pereira, M. H. Jones, P. M. Pitrez, P. J. Cooper, M. Chico, Y. Z. Chen, N. S. Zhong, C. Lai, G. Wong, M. A. Riikjärv, T. Annus, M. Gotua, M. Rukhadze, T. Abramidze, I. Kvachadze, L. Karsanidze, M. Kiladze, N. Dolidze, W. Leupold, U. Keil, E. von Mutius, S. K. Weiland, E. von Mutius, U. Keil, S. K. Weiland, P. Arthur, E. Addo-Yobo, C. Gratziou, C. Priftis, A. Papadopoulou, C. Katsardis, J. Tsanakas, E. Hatziagorou, F. Kirvassilis, M. Clausen, J. R. Shah, R. S. Mathur, R. P. Khubchandani, S. Mantri, F. Forastiere, R. Di Domenicantonio, M. De Sario, S. Sammarro, R. Pistelli, M. G. Serra, G. Corbo, C. A. Perucci, V. Svabe, D. Sebre, G. Casno, I. Novikova, L. Bagrade, B. Brunekreef, D. Schram, G. Doekes, P. H.N. Jansen-Van Vliet, N. A.H. Janssen, F. J.H. Aarts, G. de Meer, J. Crane, K. Wickens, D. Barry, W. Nystad, R. Bolle, E. Lund, N. El-Sharif, B. Nemery, F. Barghuthy, S. Abu Huij, M. Qlebo, J. Batlles Garrido, T. Rubi Ruiz, A. Bonillo Perales, Y. Gonzalez Jiménez, J. Aguirre Rodriguez, J. Momblan de Cabo, A. Losilla Maldonado, M. Daza Torres, L. Garcia-Marcos, A. Martinez Torres, J. J.Guillén Pérez, A. Piñana López, S. Castejon Robles, G. Garcia Hernandez, A. Martinez Gimeno, A. L.Moro Rodríguez, C. Luna Paredes, I. Gonzalez Gil, M. M.Morales Suarez-Varela, A. Llopis González, A. Escribano Montaner, M. Tallon Guerola, L. Bråbäck, M. Kjellman, L. Nilsson, X. M. Mai, L. Bråbäck, A. Sandin, Y. Saraçlar, S. Kuyucu, A. Tuncer, C. Saçkesen, V. Sumbuloğlu, P. Geyik, C. Kocabaş, D. Strachan, B. Kaur, N. Aït-Khaled, H. R. Anderson, M. I. Asher, R. Beasley, B. Björkstén, B. Brunekreef, P. Ellwood, C. Flohr, S. Foliaki, F. Forastiere, L. García-Marcos, U. Keil, C. Lai, J. Mallol, E. Mitchell, S. Montefort, E. von Mutius, J. Odhiambo, C. Robertson, A. Stewart, D. Strachan, S. K. Weiland, G. Weinmayr, G. Wong

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Resumen

SummaryBackground 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.

Idioma originalInglés
Páginas (desde-hasta)846-853
Número de páginas8
PublicaciónBritish Journal of Dermatology
Volumen161
N.º4
DOI
EstadoPublicada - 1 oct. 2009

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