Falissard Bruno, Simpson Eric L, Guttman-Yassky Emma, Papp Kim A, Barbarot Sebastien, Gadkari Abhijit, Saba Grece, Gautier Laurene, Abbe Adeline, Eckert Laurent
Paris Sud University, Paris, France.
Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
Dermatol Ther (Heidelb). 2020 Apr;10(2):297-305. doi: 10.1007/s13555-020-00356-0. Epub 2020 Jan 31.
Atopic dermatitis (AD) is an incurable, inflammatory skin disease characterized by skin barrier disruption and immune dysregulation. Although AD is considered a childhood disease, adult onset is possible, presenting with daily sleep disturbance and functional impairment associated with itch, neuropsychiatric issues (anxiety and depression), and reduced health-related quality of life. Although such aspects of adult AD disease burden have been measured through standardized assessments and based on population-level data, the understanding of the disease experienced at the patient level remains poor. This text-mining study assessed the impact of AD on the lives of adult patients as described from an experiential perspective.
Natural language processing (NLP) was applied to qualitative patient response data from two large-scale international cross-sectional surveys conducted in the USA and countries outside of the USA (non-USA; Canada, France, Germany, Italy, Spain, and the UK). Descriptive analysis was conducted on patient responses to an open-ended question on how they felt about their AD and how the disease affected their life. Character length, word count, and stop word (common words) count were evaluated; centrality analysis identified concepts that were most strongly interlinked.
Patients with AD in all countries were most frequently impacted by itch, pain, and embarrassment across all levels of disease severity. Patients with moderate-to-severe AD were more likely than patients with mild AD to describe sleep disturbances, fatigue, and feelings of depression, anxiety, and a lack of hope that were directly associated with AD. Centrality analysis revealed sleep disturbance was strongly linked with itch. Collectively, these concepts revealed that patients with AD are impacted by both physical and emotional burdens that are intricately connected.
Qualitative data from NLP, being more patient-centric than data from clinical standardized measures, provide a more comprehensive view of the burden of AD to inform disease management.
特应性皮炎（AD）是一种无法治愈的炎症性皮肤病，其特征为皮肤屏障破坏和免疫失调。尽管AD被认为是一种儿童疾病，但也可能在成人期发病，表现为日常睡眠障碍以及与瘙痒、神经精神问题（焦虑和抑郁）相关的功能损害，同时健康相关生活质量下降。尽管成人AD疾病负担的这些方面已通过标准化评估并基于人群水平数据进行了衡量，但对患者层面所经历疾病的了解仍然不足。本文本挖掘研究从经验角度评估了AD对成年患者生活的影响。
自然语言处理（NLP）应用于来自美国和美国以外国家（非美国；加拿大、法国、德国、意大利、西班牙和英国）进行的两项大规模国际横断面调查的定性患者反应数据。对患者关于他们对AD的感受以及该疾病如何影响其生活的开放式问题的回答进行了描述性分析。评估了字符长度、单词计数和停用词（常用词）计数；中心性分析确定了联系最紧密的概念。
在所有国家，AD患者在疾病严重程度的各个级别上最常受到瘙痒、疼痛和尴尬的影响。中重度AD患者比轻度AD患者更有可能描述与AD直接相关的睡眠障碍、疲劳以及抑郁感、焦虑感和缺乏希望的感觉。中心性分析显示睡眠障碍与瘙痒密切相关。总体而言，这些概念表明AD患者受到身体和情感负担的影响，且这些负担相互交织。
来自NLP的定性数据比临床标准化测量的数据更以患者为中心，能更全面地了解AD的负担，为疾病管理提供参考。
