Improving the quality of atopic dermatitis epidemiological research in the United States - A systematic review of disease definitions and related content in national surveys

Background: Epidemiologic study of atopic dermatitis has been critical to improve our understanding of disease burden and to identify numerous atopic and non-atopic comorbidities. Despite widespread use, atopic dermatitis case definitions and related content in population-based surveys have not been comprehensively evaluated. Objective: To characterize the state of population-based health-related surveys in the United States that include atopic dermatitis or eczema. Methods: We conducted a systematic review searching Ovid MEDLINE for population-based surveys to study atopic dermatitis in the United States from database inception through February 23, 2024. Results: Of 916 articles screened, 24 articles were included for analysis which included 11 independent surveys. Most surveys relied on self-report of physician diagnosis of atopic dermatitis or the International Study of Asthma and Allergies in Childhood (ISAAC) criteria, including a modified version of the ISAAC criteria which has not been validated. National surveys yielded the largest samples and were typically repeated annually, but some national surveys did not include questions on atopic dermatitis in recent years. Conclusion: National surveys do not use standardized definitions to identify atopic dermatitis and do not adequately capture key aspects of atopic dermatitis burden. Future population-based surveys should be designed to fill these important gaps.