Scientific article
Open access

Discordance between diagnosis tools for assessing eczema in infants: a challenge for intervention trials

Published inDermatitis, vol. 33, no. 3, p. 207-214
First online date2022-02-16

Background: There is no standardized definition for infant eczema, and various tools have been used across studies, precluding direct comparison.

Objective: The aim of the study was to assess and to compare the accuracy of diagnostic tools for infant eczema using the extensive data collected in Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR), an eczema prevention trial.

Methods: Eczema incidence was assessed by 3 questionnaire-based measures: modified UK diagnostic tool, parent-reported medically diagnosed eczema, and parent-reported use of topical corticosteroids. Agreement between the definitions was quantified using κ coefficient. Eczema severity was assessed by 3-monthly Patient-Oriented Eczema Measure (POEM) scores and a SCORing Atopic Dermatitis (SCORAD) clinical assessment at a 12-month visit (ClinicalTrial.gov: NCT01906853).

Results: Among the 538 participants fulfilling at least 1 of the 3 questionnaire-based eczema definitions, only 197 participants (37%) met all 3 definitions. Agreement between the definitions was poor with κ coefficients ranging from -0.11 to 0.62. The most frequently reported symptoms were generally dry skin (483/538, 90%) and pruritus (400/538, 74%). The face (352/538, 65%) and the trunk (306/538, 57%) were more frequently affected than the creases (257/538, 48%). Participants fulfilling all 3 questionnaire-based definitions of eczema were more likely to have higher severity scores and earlier onset of symptoms.

Conclusions: There is poor agreement between currently available tools for assessing infant eczema.

  • Dermatitis, Atopic / diagnosis
  • Dermatitis, Atopic / epidemiology
  • Eczema / diagnosis
  • Eczema / drug therapy
  • Eczema / epidemiology
  • Humans
  • Infant
  • Parents
  • Pruritus
  • Severity of Illness Index
  • Surveys and Questionnaires
Affiliation Not a UNIGE publication
Citation (ISO format)
PITTET, Laure et al. Discordance between diagnosis tools for assessing eczema in infants: a challenge for intervention trials. In: Dermatitis, 2022, vol. 33, n° 3, p. 207–214. doi: 10.1097/DER.0000000000000842
Main files (1)
Article (Accepted version)
ISSN of the journal1710-3568

Technical informations

Creation05/12/2023 8:05:33 AM
First validation11/13/2023 4:50:45 PM
Update time11/13/2023 4:50:45 PM
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