Saeki Hidehisa, Iizuka Hajime, Mori Yasuki, Akasaka Toshihide, Takagi Hajime, Kitajima Yasuo, Oiso Naoki, Kawada Akira, Tezuka Tadashi, Tanaka Toshihiko, Hide Michihiro, Yamamoto Shoso, Hirose Yasuaki, Kodama Hajime, Urabe Kazunori, Furue Masutaka, Kasagi Fumiyoshi, Morita Eishin, Tsunemi Yuichiro, Tamaki Kunihiko
Department of Dermatology, Faculty of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
J Dermatol Sci. 2007 Sep;47(3):227-31. doi: 10.1016/j.jdermsci.2007.04.006. Epub 2007 Jun 4.
A simple list of diagnostic criteria for atopic dermatitis for use in epidemiological studies was developed by a U.K. working party. This list served well for both hospital patients with skin diseases and in general population within the U.K.
To validate the U.K. diagnostic criteria in Japanese elementary schoolchildren, we collected the questionnaires on regular health checkups, which had been completed by parents of schoolchildren in 2001/2002 and 2004/2005.
Elementary schoolchildren were examined by dermatologists in eight areas (16,152 children) in 2001/2002 and in three areas (3849 children) in 2004/2005. The questionnaire was distributed to the parents 2 weeks before the skin examination, completed by the parents and collected after the survey.
In 2002/2002 comparing the U.K. diagnostic criteria with the findings on clinical examination used as the reference standard, the U.K. criteria (1-year prevalence measure) showed a sensitivity of 71.8%, specificity of 89.3% and positive predictive value of 44.7%. In 2004/2005 we confirmed that the U.K. criteria for a point prevalence measure showed a higher positive predictive value (59.9%) compared with that for 1-year prevalence measure (49.3%).
Now that we know the sensitivity and specificity of the U.K. criteria in the population examined in this study, we will be able in the near future to estimate the prevalence of atopic dermatitis in a similar population with reverse operation by questionnaires alone using these criteria without examination by dermatologists. Therefore, the validation study of U.K. criteria could be useful for future epidemiologic surveys.
英国一个工作小组制定了一份用于流行病学研究的特应性皮炎诊断标准简表。该简表在英国的皮肤病医院患者和普通人群中都适用。
为了在日本小学生中验证英国的诊断标准，我们收集了2001/2002年和2004/2005年小学生家长填写的定期健康检查问卷。
2001/2002年，皮肤科医生对八个地区的小学生（16152名儿童）进行了检查，2004/2005年对三个地区的小学生（3849名儿童）进行了检查。在皮肤检查前2周向家长发放问卷，由家长填写，调查结束后收回。
2002/2002年，将英国诊断标准与用作参考标准的临床检查结果进行比较，英国标准（1年患病率测量）的敏感性为71.8%，特异性为89.3%，阳性预测值为44.7%。2004/2005年，我们确认英国标准的现患率测量的阳性预测值（59.9%）高于1年患病率测量的阳性预测值（49.3%）。
鉴于我们已经知道英国标准在本研究人群中的敏感性和特异性，在不久的将来，我们将能够仅通过问卷使用这些标准，以反向操作的方式估计类似人群中的特应性皮炎患病率，而无需皮肤科医生进行检查。因此，英国标准的验证研究可能对未来的流行病学调查有用。
