Prevalence of adult atopic dermatitis among nursing staff in a Taiwanese medical center: a pilot study on validation of diagnostic questionnaires.
BACKGROUND
Atopic dermatitis (AD) is a chronic, relapsing dermatosis. Previous studies have focused mostly on pediatric patients, and investigations emphasizing adult AD have been limited.


OBJECTIVE
We set out to determine the 1-year prevalence and evaluate the validity of the International Study of Asthma and Allergies in Childhood (ISAAC) and United Kingdom Working Party (UKWP) AD questionnaires of adult AD in Taiwan.


METHODS
We conducted a cross-sectional study among nursing staff at a university hospital. The 1-year prevalence of AD was assessed by ISAAC and UKWP questionnaires. Subsequently, the dermatologists' diagnosis based on Hanifin and Rajka criteria was used as a reference for validation.


RESULTS
The overall response rate was 92.9%, equivalent to 1131 complete questionnaires. Ninety adult patients with AD (8%) were identified by dermatologists' diagnosis whereas ISAAC identified 107 (9.5%); sensitivity and specificity were 36.7% and 92.9%, respectively. UKWP identified 42 (3.7%) patients with AD; sensitivity and specificity were 42.2% and 99.6%, respectively. Using the receiver operating characteristic curve analysis, the UKWP criteria performed significantly better than its ISAAC counterpart. Further analysis indicated that modification of these criteria resulted in significant improvement in their diagnostic efficacy. More specifically, modified ISAAC showed 90.0% and 55.2% sensitivity and specificity, respectively, whereas modified UKWP demonstrated 82.2% and 94.2% sensitivity and specificity, respectively.


CONCLUSIONS
Most of the study subjects were female with a high educational background.


CONCLUSIONS
Currently available questionnaire instruments do not perform well in the identification of adult patients with AD. Modification of the original questionnaires may allow for future large-scale epidemiologic studies.
Lan
Cheng-Che E
CC
Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Lee
Chien-Hung
CH
Lu
Yi-Wei
YW
Lin
Chi-Ling
CL
Chiu
Hsiu-Hui
HH
Chou
Tsai-Ching
TC
Hu
Stephen Chu-Shung
SC
Wu
Ching-Ying
CY
Kim
Yi-Ying
YY
Yang
Hui-Ju
HJ
Chen
Yin-Chun
YC
Wu
Ching-Shuang
CS
Hsu
Hui-Yu
HY
Shieh
Sheng-Lan
SL
Yu
Hsin-Su
HS
Ko
Ying-Chin
YC
Chen
Gwo-Shing
GS
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D013624:Taiwan / Q000453:epidemiology