JMIR Publications

ABSTRACT

Background:

Atopic dermatitis (AD) is a chronic inflammatory cutaneous disease that affects 30.48% of young children, which needs epidemiological studies in the community settings. Web-based questionnaire (WBQ) surveys are more convenient, time-saving, and efficient than traditional surveys, but it remains unknown about the reliability of identifying AD through WBQ surveys and whether AD can be identified without doctors’ attendance, especially in the community or similar settings.

Objective:

This study aimed to develop and validate a smartphone-based identification instrument for infantile AD (electronic version of modified child eczema questionnaire, eCEQ), and to clarify the possibility of conducting WBQ surveys to identify infantile AD without doctors’ attendance in a community-representative population.

Methods:

This study was divided into two phases. Phase One investigated 205 children under 2 years old to develop and validate the eCEQ by comparison with the diagnoses of dermatologists. Phase Two recruited 1375 children under 2 years old to implement eCEQ and verify the obtained prevalence by comparison with the previously published prevalence.

Results:

In Phase One, a total of 195 questionnaires were analyzed with a median age of 8.8 (4.5, 15.0) months. The identification value of eCEQ in appropriate rules was acceptable (logic rule: sensitivity 89.2%, specificity 91.5%, positive predictive value 97.1%, negative predictive value 72.9%; statistic rule: sensitivity 90.5%, specificity 89.4%, positive predictive value 96.4%, negative predictive value 75.0%). In Phase Two, a total of 837 questionnaires were analyzed with a median age of 8.4 (5.2, 14.6) months. The prevalence of infantile AD obtained by eCEQ (logic rule) was 31.9% (267/837) which was close to the published prevalence (30.48%).

Conclusions:

Infantile AD can be identified without doctors’ attendance by using the eCEQ, which can be easily applied to community-based epidemiological studies and provide acceptable reliability of identification. In addition, the eCEQ can also be applied to the field of public health to improve the health awareness of the general population.