Williams H C, Burney P G, Hay R J, Archer C B, Shipley M J, Hunter J J, Bingham E A, Finlay A Y, Pembroke A C, Graham-Brown R A
St John's Institute of Dermatology, London, U.K.
Br J Dermatol. 1994 Sep;131(3):383-96. doi: 10.1111/j.1365-2133.1994.tb08530.x.
A working party of 13 dermatologists, two family practitioners and a paediatrician was assembled, with the aim of developing a minimum list of reliable discriminators for atopic dermatitis. Each physician was asked to select 10 consecutive new cases of unequivocal mild to moderate atopic dermatitis and 10 controls with other inflammatory dermatoses. Each subject was examined by two independent observers, who were blind to the clinical diagnosis and study aim, with regard to 31 clinically useful diagnostic features for atopic dermatitis. Two hundred and twenty-four patients were studied (120 cases and 102 controls). Using the key physician's clinical diagnosis as a gold standard, the sensitivity and specificity of each of the 31 diagnostic criteria were tested. Using multiple logistic regression techniques, a minimum set of diagnostic criteria for atopic dermatitis was derived. These were: history of flexural involvement, history of a dry skin, onset under the age of 2, personal history of asthma, history of a pruritic skin condition, and visible flexural dermatitis. Adjustment for age, sex, region, social class and ethnic group did not alter the choice of final criteria. The discriminatory value of these criteria was also satisfactory when tested against a further sample of 150 patients drawn from the community, who did not have skin disease.
一个由13名皮肤科医生、两名家庭医生和一名儿科医生组成的工作小组组建起来，目的是制定一份特应性皮炎可靠鉴别因素的最低清单。要求每位医生挑选10例连续的明确的轻度至中度特应性皮炎新病例以及10例患有其他炎症性皮肤病的对照。两名独立观察者对每位受试者进行检查，他们对临床诊断和研究目的不知情，检查涉及31项对特应性皮炎临床有用的诊断特征。共研究了224名患者（120例病例和102例对照）。以关键医生的临床诊断作为金标准，对31项诊断标准中的每一项的敏感性和特异性进行了测试。使用多元逻辑回归技术，得出了一套特应性皮炎的最低诊断标准。这些标准是：屈侧受累史、干性皮肤史、2岁前发病、哮喘个人史、瘙痒性皮肤病史以及可见的屈侧皮炎。对年龄、性别、地区、社会阶层和种族进行调整后，并未改变最终标准的选择。当针对从社区抽取的另外150名无皮肤疾病的患者样本进行测试时，这些标准的鉴别价值也令人满意。
