Developing and validating an identification tool for infantile atopic dermatitis based on smartphones: web-based survey pilot study (Preprint)

BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects 30.48% of young children. Epidemiological studies need to be conducted in the community. Web-based questionnaire (WBQ) surveys are more convenient, time-saving, and efficient than traditional surveys, but it remains unknown whether AD can be identified without the attendance of doctors in WBQ surveys. OBJECTIVE The aim of this study was to test the possibility of conducting WBQ surveys without the attendance of doctors, and to develop and validate an electronic version of modified child eczema questionnaire (eCEQ) based on a smartphone to identify infantile AD. 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 verify the prevalence obtained by the eCEQ by comparison with the prevalence published previously. RESULTS In Phase One, 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, 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 the attendance of doctors through WBQ surveys. The eCEQ can be easily applied to epidemiological studies and provides acceptable reliability of identification. It can also be applied to the field of public health to improve the health awareness of the general population.