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：特应性皮炎（atopic dermatitis）的流行病学研究，对于深化我们对该疾病负担的认知、识别多种特应性与非特应性共病至关重要。尽管特应性皮炎的病例定义及相关内容在人群调查中应用广泛，但目前尚未得到全面评估。
目的：系统刻画美国纳入特应性皮炎或湿疹（eczema）研究的人群健康相关调查的现状。
方法：本研究开展系统综述，检索Ovid MEDLINE数据库，筛选数据库自建库至2024年2月23日期间发表的、针对美国人群特应性皮炎的相关调查研究。
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。多数调查采用基于医师诊断的自我报告方式，或采用儿童哮喘与过敏性疾病国际研究（International Study of Asthma and Allergies in Childhood, ISAAC）制定的标准，其中包含经修改但未经验证的ISAAC标准变体。全国性调查的样本规模最大，且通常每年重复开展，但部分全国性调查近年已不再纳入特应性皮炎相关调研问题。
结论：当前美国全国性调查未采用标准化定义来识别特应性皮炎，且未能充分覆盖该疾病负担的关键维度。未来的人群健康调查应针对性设计，以填补上述重要研究空白。