Objective:To develop novel, questionnaire-based diagnostic criteria to improve the accuracy of estimations of AD prevalence and individual diagnoses of childhood AD in epidemiologic surveys.
Methods:Candidate questions for questionnaire were selected by preliminary surveys. The Reliable Estimation of Atopic dermatitis in ChildHood (REACH) diagnostic criteria were derived from a population-based survey.
Results: Thirteen questions (2 major and 11 minor criteria) were included in the final version of the questionnaire. The REACH diagnostic criteria were defined as fulfillment of the two major criteria (2M) for ‘typical AD’, or one major plus four or more minor criteria (2M + 4m) for ‘atypical AD’, from the derivation set (n=1,129). The REACH criteria demonstrated superior performance compared to the ISAAC both in terms of estimated AD prevalence and diagnostic accuracy in a validation set (n=1,191).
Limitations: Further validation is required using a more-diverse range of populations.
Conclusions: We propose that the comprehensive, questionnaire-based REACH diagnostic criteria can be used for childhood AD, not only in epidemiological surveys but also in the context of personalized medical advice.