Evaluation of diagnostic criteria for atopic dermatitis: validity of the criteria of Williams et al. in a hospital-based setting

Authors

  • H. Gu,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • X.S. Chen,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • K. Chen,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • Y. Yan,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • H. Jing,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • X.Q. Chen,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • C.G. Shao,

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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  • G.Y. Ye

    1. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang-wang-miao Road,
      Nanjing 210042, China *Medical College of Jinan University, China†Department of Dermatology, People's Hospital, Peking Medical College, Beijing 100044, China
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Dr Gu Heng. E-mail: guhengy@jlonline.com

Abstract

Background  Surveys of the prevalence of atopic dermatitis (AD) have been carried out world-wide, but the results vary widely. The differences probably result from the use of different diagnostic criteria. Williams et al. proposed minimum, simplified, diagnostic criteria that require no invasive test and are easy to use. Pilot studies in European countries showed their suitability for implementation both in hospitals and in the community, and their high sensitivity and specificity.

Objectives  To evaluate the potential practical value of the criteria of Williams et al. in the Chinese population.

Methods  The criteria of Hanifin and Rajka (gold standard), Williams et al. and Kang and Tian were applied and compared in 111 patients with AD and 121 control subjects with other skin diseases in three out-patient centres in China.

Results  The criteria of Williams et al. showed a similar diagnostic efficiency to that of the gold standard, with the sensitivity, specificity and κ value reaching 95·50%, 97·52% and 0·93, respectively. No significant difference was found between the criteria of Williams et al. and those of Kang and Tian (χ2 = 0·69, P > 0·05). ‘Onset under the age of 2 years’, a criterion of Williams et al. could be used in subjects of any age.

Conclusions  The diagnostic efficiency of the criteria of Williams et al. was basically similar to those of Hanifin and Rajka and of Kang and Tian in our out-patient settings. However, those of Williams et al. were easier to apply and required no invasive tests.

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