title: Prevalence of adult atopic dermatitis among nursing staff in a Taiwanese medical center: a pilot study on validation of diagnostic questionnaires.
abstract: 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.
authors: Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Cheng-Che E
authors: CC
authors: Lan
authors: Chien-Hung
authors: CH
authors: Lee
authors: Yi-Wei
authors: YW
authors: Lu
authors: Chi-Ling
authors: CL
authors: Lin
authors: Hsiu-Hui
authors: HH
authors: Chiu
authors: Tsai-Ching
authors: TC
authors: Chou
authors: Stephen Chu-Shung
authors: SC
authors: Hu
authors: Ching-Ying
authors: CY
authors: Wu
authors: Yi-Ying
authors: YY
authors: Kim
authors: Hui-Ju
authors: HJ
authors: Yang
authors: Yin-Chun
authors: YC
authors: Chen
authors: Ching-Shuang
authors: CS
authors: Wu
authors: Hui-Yu
authors: HY
authors: Hsu
authors: Sheng-Lan
authors: SL
authors: Shieh
authors: Hsin-Su
authors: HS
authors: Yu
authors: Ying-Chin
authors: YC
authors: Ko
authors: Gwo-Shing
authors: GS
authors: Chen
mesh_terms: 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