title: Introduction of the Reliable Estimation of Atopic Dermatitis in ChildHood: Novel, Diagnostic Criteria for Childhood Atopic Dermatitis.
abstract: OBJECTIVE
  Questionnaire-based diagnostic criteria for atopic dermatitis (AD) have been proposed to detect the major group of AD with flexural dermatitis. We aimed to develop novel, questionnaire-based diagnostic criteria for childhood AD, which can detect more comprehensive AD including non-flexural type.
  
  
  METHODS
  The draft version of questionnaire to detect childhood AD was prepared to be used for preliminary hospital- (n=1,756) and community-based (n=1,320) surveys. From analysis, the Reliable Estimation of Atopic dermatitis of ChildHood (REACH) was derived and verified in derivation (n=1,129) and validation (n=1,191) sets by community-based surveys.
  
  
  RESULTS
  The REACH consists of 11 questions including 2 major and 9 minor criteria. AD is diagnosed as the major group of 'eczema on the antecubital or popliteal fossa' to fulfill the 2 major criteria (2M), and the minor group of 'eczema on the non-antecubital or popliteal fossa' to fulfill the 1 major plus 4 or more minor criteria (1M+4m). In the validation set, the overall 1-year AD prevalence by the REACH was estimated as 12.3% (95% CI, 10.5%-14.2%), and the REACH showed a sensitivity of 75.2%, a specificity of 96.1%, and an error rate of 6.4%. The REACH demonstrated better diagnostic performance than the ISAAC in terms of the number of misclassification (10.0%).
  
  
  CONCLUSIONS
  We propose the REACH as new full, questionnaire-based diagnostic criteria for childhood AD in epidemiological surveys. Further studies are warranted to validate the REACH in different populations or countries in the context of large-scale, epidemiological surveys.
authors.affiliation: Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. schul@jnu.ac.kr.
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Department of Dermatology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Bae
authors.affiliation: Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Seoul Medical Center, Seoul, Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kapsok
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jae We
authors.initials: JW
authors.lastname: Cho
authors.affiliation: Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang Ook
authors.initials: CO
authors.lastname: Park
authors.affiliation: Department of Dermatology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Kyungpook National University College of Medicine, Daegu, Korea.
authors.forename: Do Won
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Chun Wook
authors.initials: CW
authors.lastname: Park
authors.affiliation: Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyu Han
authors.initials: KH
authors.lastname: Kim
keywords: Atopic dermatitis; REACH; diagnostic criteria; questionnnaire