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Concordance Between Physician-rated and Caregiver-perceived Disease Severity in Children with Atopic Dermatitis: A Cross-sectional Study

Authors :
Xiaomeng Xu
Maja Olsson
Ram Bajpai
Mark Koh Aan
Yik Weng Yew
Sharon Wong
Alice Foong
Steven Thng
Krister Järbrink
Josip Car
Source :
Acta Dermato-Venereologica, Vol 100, Iss 18, p adv00308 (2020)
Publication Year :
2020
Publisher :
Medical Journals Sweden, 2020.

Abstract

This study examined concordance between caregiver-reported and physician-rated estimates of severity of atopic dermatitis (AD) in paediatric patients and explored potential explanatory factors. Physician-reported severity of AD was retrieved from medical records, while caregiver-reported disease severity and sociodemographic data were obtained through a survey that also collected information on out-of-pocket expenses due to AD. There was 38.5% (95% confidence interval (95% CI) 30.1, 43.5) disagreement between physician and caregivers with regards to both underestimating and overestimating the condition. A duration since AD diagnosis shorter than 6 months showed higher concordance (kappa: 44.4%; 95% CI 30.6, 58.2) between caregiver and physician estimates of AD severity compared with a duration of 6 months or longer. Caregivers underestimating their child’s AD accounted for 27.7% among all participants, while 10.8% overestimated the severity of AD compared with physicians. Factors significantly associated with caregiver’s underestimation of disease severity were age of the child and time since disease diagnosis. Comparison of concordance between caregiver-reported and physician-rated estimates of severity of AD in paediatric patients revealed a tendency amongst caregivers to underestimate severity of AD. This information may have clinical implications for treatment outcomes if caregivers fail to adhere to medical advice.

Details

Language :
English
ISSN :
00015555 and 16512057
Volume :
100
Issue :
18
Database :
Directory of Open Access Journals
Journal :
Acta Dermato-Venereologica
Publication Type :
Academic Journal
Accession number :
edsdoj.0d60bc88a70340798341fb813dfc7980
Document Type :
article
Full Text :
https://doi.org/10.2340/00015555-3540