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.背景：异位性皮炎（atopic dermatitis）的流行病学研究对加深我们对疾病负担的认知、识别多种特应性与非特应性共病至关重要。尽管相关应用已十分广泛，但基于人群的调查中关于异位性皮炎的病例定义及相关内容尚未得到全面评估。 研究目的：系统梳理美国纳入异位性皮炎或湿疹（eczema）的人群健康相关调查现状。 研究方法：本研究开展了一项系统综述，检索Ovid MEDLINE数据库自建库起至2024年2月23日期间收录的、针对美国人群异位性皮炎研究的相关人群调查文献。 研究结果：本次共筛选916篇文献，最终纳入24篇进行分析，涵盖11项独立调查。多数调查采用医师诊断异位性皮炎的自我报告方式，或采用儿童哮喘与过敏国际研究（International Study of Asthma and Allergies in Childhood, ISAAC）标准，其中包含1项尚未经过验证的ISAAC标准改良版本。全国性调查的样本量最大，且通常每年重复开展，但部分全国性调查近年已不再设置异位性皮炎相关问卷条目。 研究结论：当前美国全国性调查未采用标准化定义来识别异位性皮炎，也未能充分覆盖疾病负担的关键维度。未来的人群调查应针对性设计，以填补上述重要研究空白。