Williams H C, Burney P G, Pembroke A C, Hay R J
St John's Institute of Dermatology, United Medical School of Guy's Hospital, London, U.K.
Br J Dermatol. 1996 Jul;135(1):12-7.
One reason why so little is known about the epidemiology of atopic dermatitis (AD) is lack of suitable diagnostic criteria. A simple list of diagnostic criteria for AD for use in epidemiological studies has recently been developed by a U.K. working party. These have performed well in hospital validation studies of subjects with skin diseases. This study sought to validate the newly proposed criteria for AD in a population setting by conducting a cross-sectional survey of 695 schoolchildren aged 3-11 years in three randomly selected primary schools in West Lambeth, London. As a point prevalence measure, the U.K. criteria had a sensitivity of 70%, a specificity of 93%, and a positive predictive value of 47% when compared with a dermatologist's examination findings. Subsequent analysis suggested that most children classified as false positives had suffered from AD in the last year, but were inactive at the time of examination. When adjusted for these cases, the sensitivity and specificity increased to 80 and 97%, respectively, corresponding to positive and negative predictive values of 80 and 97%, respectively. The U.K. diagnostic criteria for AD appear to work well as a 1-year period prevalence measure in London schoolchildren. Further validation in adults and other countries are needed.
关于特应性皮炎（AD）流行病学的了解如此之少的一个原因是缺乏合适的诊断标准。英国一个工作组最近制定了一份用于流行病学研究的AD诊断标准简表。这些标准在患有皮肤病的受试者的医院验证研究中表现良好。本研究通过对伦敦西兰贝斯区三所随机选择的小学中695名3至11岁的学童进行横断面调查，试图在人群环境中验证新提出的AD标准。作为时点患病率测量指标，与皮肤科医生的检查结果相比，英国标准的敏感性为70%，特异性为93%，阳性预测值为47%。后续分析表明，大多数被归类为假阳性的儿童在过去一年患有AD，但在检查时病情处于静止期。对这些病例进行调整后，敏感性和特异性分别提高到80%和97%，相应的阳性和阴性预测值分别为80%和97%。英国的AD诊断标准作为伦敦学童1年期间患病率测量指标似乎效果良好。需要在成年人和其他国家进一步验证。
