title: Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review.
abstract: OBJECTIVE
  To examine whether significant differences exist between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice.
  
  
  METHODS
  Medline (OvidSP), PubMed Publisher, EMBASE, Google Scholar and the Cochrane Controlled Clinical Trials Register databases were systematically reviewed for articles providing data on the prevalence of asthma, allergic rhinitis and eczema in a GP setting. Studies were only included when they had a cross-sectional or cohort design and included more than 100 children (aged 0-18 years) in a general practice setting. All ISAAC studies (i.e. the open population) that geographically matched a study selected from the first search, were also included. A quality assessment was conducted. The primary outcome measures were prevalence of eczema, asthma and allergic rhinitis in children aged 0-18 years.
  
  
  RESULTS
  The overall quality of the included studies was good. The annual and lifetime prevalences of the atopic disorders varied greatly in both general practice and the open population. On average, the prevalence of atopic disorders was higher in the open population.
  
  
  CONCLUSIONS
  There are significant differences between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Data obtained in the open population cannot simply be extrapolated to the general practice setting. This should be taken into account when considering a research topic or requirements for policy development. GPs should be aware of the possible misclassification of allergic disorders in their practice. Key Points Epidemiological data on atopic disorders in children can be obtained from various sources, each having its own advantages and limitations. On average, the prevalence of atopic disorders is higher in the open population. GPs should take into account the possible misclassification of atopic disorders in their practice population. Policymakers should be aware that data obtained in the open population cannot simply be extrapolated to the general practice setting.
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: D H J
authors.initials: DH
authors.lastname: Pols
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: Wartna
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Moed
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: E I
authors.initials: EI
authors.lastname: van Alphen
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Bohnen
authors.affiliation: a Department of General Practice, Erasmus MC , University Medical Center Rotterdam , The Netherlands.
authors.forename: P J E
authors.initials: PJ
authors.lastname: Bindels
mesh_terms: D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000453:epidemiology*; D003951:Diagnostic Errors; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000453:epidemiology*; D057566:Self Report; D006113:United Kingdom / Q000453:epidemiology
keywords: Allergic rhinitis; The Netherlands; asthma; atopic eczema; epidemiology; general practice; primary care