Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Abstract

Background

Epidemiologic studies of atopic dermatitis are often limited by case definitions that have not been validated.

Objective

In this study, we assessed the accuracy of self‐report of atopic dermatitis in a large cohort of US female nurses, the Nurses' Health Study 2 (NHS2). We also provide clinical characteristics of atopic dermatitis in the cohort.

Methods

We sent an electronic questionnaire to NHS2 participants who previously reported ever having a diagnosis of atopic dermatitis. This questionnaire was designed to confirm cases of atopic dermatitis using previously validated algorithms with >85% specificity. We assessed the association of atopic dermatitis with asthma, comparing the results when different definitions of atopic dermatitis were applied. We also inquired about various aspects of participants' atopic dermatitis.

Results

Responses were received from 2,509 of 5,126 (49%) nurses who were sent the questionnaire, with an average age of 62. Most participants (1,996/2,509, 80%) reiterated their previously reported clinician diagnosis of atopic dermatitis. Application of the two diagnostic algorithms yielded confirmation of 1,538 and 1,293 prevalent cases, respectively. The association of atopic dermatitis with asthma was stronger when more stringent atopic dermatitis case definitions were applied. Participants generally reported mild disease (92% with ≤10% maximal body surface area involved) and a high proportion (57%) reported adult‐onset disease.

Conclusions

Self‐report of atopic dermatitis diagnosis has good reliability, and future analyses will be strengthened by our ability to conduct sensitivity analyses with refined confirmed atopic dermatitis subgroups.

This article is protected by copyright. All rights reserved.

https://ift.tt/2DVb8e6