Migliavaca Celina Borges, Lazzarini Rosana, Stein Cinara, Escher Gabrielle Nunes, de Gaspari Camilla Natal, Dos Santos Harryson Wings Godoy, Myers Daniela E, Lemeshow Adina R, Pinheiro Márcia Regina Teixeira, Falavigna Maicon, Pachito Daniela V
From the HTA Unit, Inova Medical, Porto Alegre, Brazil.
Post-Graduate Program of Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Dermatitis. 2024 Aug 12. doi: 10.1089/derm.2024.0165.
Atopic dermatitis (AD) negatively affects quality of life and places a substantial financial burden on health care systems due to treatment costs and increased demand for services. To estimate the worldwide prevalence of AD, the proportion of severe cases worldwide and explore sources of heterogeneity. We searched MEDLINE, Embase, and Global Index Medicus from January 2012 up until August 30, 2022. We included primary prevalence studies published from 2012 onward. Study selection was conducted by two reviewers independently. One reviewer performed data extraction and assessed risk of bias using the JBI Critical Appraisal Checklist for Prevalence Studies, with independent checking by a second reviewer. Random-effects meta-analyses were conducted to pool results; subgroup analyses were conducted to evaluate potential modifiers. Certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Main outcomes were point prevalence and proportion of severe cases. We identified 12,774 unique references and assessed 1029 full texts, ultimately resulting in the inclusion of 310 studies with 25.5 million individuals. Point prevalence was 11.1% (95% CI 9.4-13.1; 123 studies; 12,776,910 individuals; moderate certainty of evidence) in children and adolescents, and 6.3% (95% CI 5.0-7.8; 59 studies; 12,794,260 individuals; moderate certainty of evidence) in adults. Relatively similar results were observed for studies with low risk of bias. Proportion of severe cases varied from 1.9 to 7.2% in children and adolescents and 2.8% to 15.6% in adults. These findings may underpin effective health care policies, research initiatives, and clinical decision-making.
特应性皮炎(AD)对生活质量产生负面影响,并且由于治疗成本和服务需求增加,给医疗保健系统带来了沉重的经济负担。为了估计全球AD的患病率、全球重症病例的比例,并探索异质性来源。我们检索了2012年1月至2022年8月30日期间的MEDLINE、Embase和全球医学索引。我们纳入了2012年以后发表的原发性患病率研究。由两名评审员独立进行研究选择。一名评审员进行数据提取,并使用JBI患病率研究批判性评价清单评估偏倚风险,由另一名评审员进行独立核对。进行随机效应荟萃分析以汇总结果;进行亚组分析以评估潜在的影响因素。使用推荐分级评估、制定和评价方法对证据的确定性进行评级。主要结果是时点患病率和重症病例比例。我们识别出12774篇独特的参考文献,并评估了1029篇全文,最终纳入了310项研究,涉及2550万人。儿童和青少年的时点患病率为11.1%(95%CI 9.4-13.1;123项研究;12776910人;证据确定性中等),成人的时点患病率为6.3%(95%CI 5.0-7.8;59项研究;12794260人;证据确定性中等)。对于偏倚风险较低的研究,观察到了相对相似的结果。儿童和青少年重症病例的比例在1.9%至7.2%之间,成人在2.8%至15.6%之间。这些发现可能为有效的医疗保健政策、研究倡议和临床决策提供依据。