Massachusetts General Hospital, Clinical Unit for Research Trials and Outcomes in Skin, Boston, MA, USA.
J Eur Acad Dermatol Venereol. 2013 Jun;27(6):680-5. doi: 10.1111/j.1468-3083.2012.04531.x. Epub 2012 Apr 4.
Validated epidemiological estimates of the prevalence of skin diseases remain an unmet challenge. Most patients in many health care systems do not see dermatologists for skin problems. Assessments based on claims data or self-report are likely to contain substantial misclassification. Population-based in-person dermatological exams have proven impractical because of the number of patients required. However, in the US, there is a large skin cancer screening program where volunteer dermatologists assess almost 100,000 people annually.
To evaluate the utility of this program for the assessment of other diseases.
Information concerning prior diagnosis of psoriasis, type of insurance and physician's current assessment of psoriasis was captured as part of the American Academy of Dermatology National Melanoma/Skin Cancer Screening Program. A modified form was provided to a subset of participant sites. Overall and subgroup prevalence of psoriasis was analysed. Crude and adjusted results are presented for comparison to the US population.
Among the 2991 participants, 86% answered the self-report psoriasis question. A previous diagnosis of psoriasis was reported by 5.1% of them. This proportion was greater than the prevalence of physician documented diagnosis of psoriasis (2.8%). Analyses with different assumptions to account for missing values and weighting based on US population estimates yielded prevalence values ranging from 1.2% to 3.4%.
This project, although limited by missing data, is consistent with previous findings that psoriasis prevalence is between 2.2% and 4.6% in the US. It demonstrates the potential to evaluate prevalence of other skin conditions through existing national activities.
皮肤疾病流行率的经过验证的流行病学估计仍然是一个未满足的挑战。在许多医疗保健系统中,大多数患者并未因皮肤问题而就诊皮肤科医生。基于索赔数据或自我报告的评估可能存在大量分类错误。基于人群的亲自皮肤科检查由于所需患者数量而证明不切实际。然而,在美国,有一个大型皮肤癌筛查计划,每年有近 100,000 名志愿者皮肤科医生对其进行评估。
评估该计划对其他疾病评估的效用。
在皮肤科医生美国协会的国家黑色素瘤/皮肤癌筛查计划中,部分参与者需要记录有关先前银屑病诊断、保险类型和医生目前对银屑病的评估的信息。为参与者提供了一份经过修改的表格。分析了银屑病的总体和亚组流行率。呈现了未经调整和调整后的结果,以便与美国人口进行比较。
在 2991 名参与者中,86%回答了自我报告的银屑病问题。其中 5.1%的人报告了以前的银屑病诊断。这一比例大于医生记录的银屑病诊断比例(2.8%)。通过不同的假设分析来解释缺失值,并根据美国人口估计进行加权,得出的患病率范围从 1.2%到 3.4%。
尽管本项目受到数据缺失的限制,但与之前的发现一致,即美国的银屑病患病率在 2.2%到 4.6%之间。它表明通过现有国家活动评估其他皮肤状况患病率的潜力。