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Saeki H, Ohya Y, Furuta J, Arakawa H, Ichiyama S, Katsunuma T, Katoh N, Tanaka A, Tsunemi Y, Nakahara T, Nagao M, Narita M, Hide M, Fujisawa T, Futamura M, Masuda K, Matsubara T, Murota H, Yamamoto-Hanada K. English Version of Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021. J Dermatol 2022; 49:e315-e375. [PMID: 35996152 DOI: 10.1111/1346-8138.16527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
This is the English version of the Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021. Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. In Japan, from the perspective of evidence-based medicine, the current strategies for the treatment of AD consist of three primary measures: (i) use of topical corticosteroids, tacrolimus ointment, and delgocitinib ointment as the main treatment of the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling, and advice about daily life. In the present revised guidelines, descriptions of three new drugs, namely, dupilumab, delgocitinib, and baricitinib, have been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
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Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Junichi Furuta
- Medical Informatics and Management, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirokazu Arakawa
- Kitakanto Allergy Research Institute, Kibounoie Hospital, Midori, Japan
| | - Susumu Ichiyama
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Toshio Katsunuma
- Department of Pediatrics, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Norito Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichiro Tsunemi
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Masami Narita
- Department of Pediatrics, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Michihiro Hide
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Dermatology, Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Masaki Futamura
- Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koji Masuda
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Tomoyo Matsubara
- Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kaundinya T, Rakita U, Guraya A, Abboud DM, Croce E, Thyssen JP, Alexis A, Silverberg JI. Differences in Psychometric Properties of Clinician- and Patient-Reported Outcome Measures for Atopic Dermatitis by Race and Skin Tone: A Systematic Review. J Invest Dermatol 2022; 142:364-381. [PMID: 34352262 PMCID: PMC8792149 DOI: 10.1016/j.jid.2021.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 02/03/2023]
Abstract
The psychometric validity and reliability of widely used atopic dermatitis (AD) outcome measures across different races and ethnicities are unclear. We describe the rates of reporting race, ethnicity, and skin tone in studies testing the psychometric properties of AD outcome measures and compare the psychometric analyses across race, ethnicity, and skin tone. We systematically reviewed MEDLINE and EMBASE for studies reporting psychometric properties of clinician-reported or patient-reported outcome measures in AD (International Prospective Register of Systematic Reviews: CRD42021239614). Overall, 16,100 nonduplicate articles were screened; 165 met inclusion criteria. Race and/or ethnicity were reported in 55 (33.3%) studies; of those, race was assessed by self-report in 10 studies (6.1%) or was unspecified in 45 (27.3%). A total of 16 studies (9.7%) evaluated psychometric property differences by race, and only five (4.4%) of those did not recognize it as a limitation. Properties assessed across race, ethnicity, or skin tone were differential item functioning, convergent validity feasibility, inter-rater reliability, intrarater reliability, test‒retest reliability, and known-groups validity. Multiple instruments demonstrated performance differences across ethnoracial groups. This review highlights the paucity of race/ethnicity consideration for psychometric property testing in AD outcome measurement instruments. More AD outcomes instruments should be validated in diverse populations.
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Affiliation(s)
- Trisha Kaundinya
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Uros Rakita
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Armaan Guraya
- Chicago College of Osteopathic Medicine, Midwestern University, Chicago, Illinois, USA
| | | | - Emily Croce
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA; Pediatric and Adolescent Dermatology, Dell Children's Medical Group, Austin, Texas, USA
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew Alexis
- Dermatology, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
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Katoh N, Ohya Y, Ikeda M, Ebihara T, Katayama I, Saeki H, Shimojo N, Tanaka A, Nakahara T, Nagao M, Hide M, Fujita Y, Fujisawa T, Futamura M, Masuda K, Murota H, Yamamoto-Hanada K. Japanese guidelines for atopic dermatitis 2020. Allergol Int 2020; 69:356-369. [PMID: 32265116 DOI: 10.1016/j.alit.2020.02.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 01/04/2023] Open
Abstract
Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion, which is frequently encountered in clinical practice. Skin barrier dysfunction leads to enhanced skin irritability to non-specific stimuli and epicutaneous sensitization. In the lesion site, a further inflammation-related reduction in skin barrier function, enhanced irritability and scratching-related stimuli deteriorate eczema, leading to vicious cycle of inflammation. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
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Affiliation(s)
- Norito Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masanori Ikeda
- Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Tamotsu Ebihara
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Katayama
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Graduate School of Medicine, Nihon Medical School, Tokyo, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akio Tanaka
- Department of Dermatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Takeshi Nakahara
- Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuho Nagao
- Division of Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Michihiro Hide
- Department of Dermatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yuji Fujita
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takao Fujisawa
- Division of Allergy, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Masaki Futamura
- Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koji Masuda
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Gabes M, Tischer C, Apfelbacher C. Measurement properties of quality-of-life outcome measures for children and adults with eczema: An updated systematic review. Pediatr Allergy Immunol 2020; 31:66-77. [PMID: 31505076 DOI: 10.1111/pai.13120] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/05/2019] [Accepted: 08/22/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this updated systematic review was to systematically assess the measurement properties of previously discussed and new quality-of-life patient-reported outcome measures (PROMs) in children and adults with eczema using the new COSMIN guideline. METHODS A systematic literature search was conducted in PubMed and EMBASE. Eligible studies reported on measurement properties of quality-of-life PROMs for children and adults with eczema. The methodological quality of selected already known PROMs and new evidence identified through the literature search was assessed with the COSMIN Risk of Bias checklist. The adequacy of included PROMs was judged with updated quality criteria, and the quality of evidence of the summarized results was graded. Finally, PROMs were placed in a recommendation category (A-C). RESULTS In total, 133 measurement properties of nine different PROMs were assessed. No PROM could be placed in category A due to a lack of validation studies. Only the DLQI fulfilled the criteria for category C and therefore should not be recommended for use. All other PROMs were placed in category B, that is, they still have the opportunity to be recommended, but need further validation. CONCLUSIONS Currently, no PROM for quality of life can be recommended for use in children and adults with eczema. Further validation is needed. The DLQI cannot be recommended for future use.
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Affiliation(s)
- Michaela Gabes
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Christina Tischer
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Christian Apfelbacher
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.,Institute of Social Medicine and Health Economics, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Katoh N, Ohya Y, Ikeda M, Ebihara T, Katayama I, Saeki H, Shimojo N, Tanaka A, Nakahara T, Nagao M, Hide M, Fujita Y, Fujisawa T, Futamura M, Masuda K, Murota H, Yamamoto-Hanada K. Clinical practice guidelines for the management of atopic dermatitis 2018. J Dermatol 2019; 46:1053-1101. [PMID: 31599013 DOI: 10.1111/1346-8138.15090] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/21/2022]
Abstract
Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
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Affiliation(s)
- Norito Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masanori Ikeda
- Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmacuetical Sciences, Okayama, Japan
| | - Tamotsu Ebihara
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Katayama
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Graduate School of Medicine, Nihon Medical School, Tokyo, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of medicine, Chiba University, Chiba, Japan
| | - Akio Tanaka
- Department of Dermatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Takeshi Nakahara
- Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuho Nagao
- Division of, Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Michihiro Hide
- Department of Dermatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yuji Fujita
- Department of Pediatrics, Graduate School of medicine, Chiba University, Chiba, Japan
| | - Takao Fujisawa
- Division of, Allergy, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Masaki Futamura
- Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koji Masuda
- Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Gabes M, Chamlin S, Lai J, Cella D, Mancini A, Apfelbacher C. Evaluation of responsiveness and estimation of smallest detectable change and minimal important change scores for the Childhood Atopic Dermatitis Impact Scale. Br J Dermatol 2019; 182:348-354. [DOI: 10.1111/bjd.18204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gabes
- Medical Sociology Department of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
| | - S.L. Chamlin
- Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern Feinberg School of Medicine Chicago IL U.S.A
| | - J.‐S. Lai
- Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago IL U.S.A
| | - D. Cella
- Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago IL U.S.A
| | - A.J. Mancini
- Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern Feinberg School of Medicine Chicago IL U.S.A
| | - C.J. Apfelbacher
- Medical Sociology Department of Epidemiology and Preventive Medicine University of Regensburg Regensburg Germany
- Institute of Social Medicine and Health Economics Otto‐von‐Guericke‐University Magdeburg Magdeburg Germany
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Yamaguchi C, Ebara T, Hosokawa R, Futamura M, Ohya Y, Asano M. Factors determining parenting stress in mothers of children with atopic dermatitis. Allergol Int 2019; 68:185-190. [PMID: 30217405 DOI: 10.1016/j.alit.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 07/11/2018] [Accepted: 08/14/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) influences a child's emotional and social well-being, as well as his or her physical health. The influence of AD on the daily lives of parents and caregivers has also been documented. This study examined how parenting stress is affected by demographic background, characteristics of children's AD, and their family systems. METHODS The participants were mothers of children, aged 2-6 years old, who had been diagnosed with AD. The predictive power of a model of parenting stress was examined using multiple regression analysis (stepwise), with parenting stress (PSI-SF) as the dependent variable, and children's demographics, including characteristics of AD; parents' demographics; QoL of families of children with AD (JCMV-CADIS); and family functioning (FAI) as independent variables. We handled missing values using a multiple imputation method. RESULTS The pooled coefficients obtained from the multiple regression analysis after multiple imputation indicated that "family cohesion," "family system flexibility," "emotions related to social factors" and "occupation of mother" determined parenting stress. Lower family cohesion and family system flexibility predicted higher parenting stress. The high impact of "emotions related to social factors" on families' QoL predicted higher parenting stress. Full-time work by mothers predicted lower parenting stress. CONCLUSIONS The current results reveal that "family cohesion," "family system flexibility," "emotions related to social factors" and "full-time work by mothers" predicted parenting stress of mothers who had children with AD.
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Chu CY. Measuring quality of life in infants, children and adolescents with eczema. Br J Dermatol 2017; 176:848-849. [PMID: 28418131 DOI: 10.1111/bjd.15215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C-Y Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan
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Heinl D, Prinsen CAC, Sach T, Drucker AM, Ofenloch R, Flohr C, Apfelbacher C. Measurement properties of quality-of-life measurement instruments for infants, children and adolescents with eczema: a systematic review. Br J Dermatol 2017; 176:878-889. [PMID: 27543747 DOI: 10.1111/bjd.14966] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Quality of life (QoL) is one of the core outcome domains identified by the Harmonising Outcome Measures for Eczema (HOME) initiative to be assessed in every eczema trial. There is uncertainty about the most appropriate QoL instrument to measure this domain in infants, children and adolescents. OBJECTIVES To systematically evaluate the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in infants, children and adolescents with eczema. METHODS A systematic literature search in PubMed and Embase, complemented by a thorough hand search of reference lists, retrieved studies on measurement properties of eczema QoL instruments for infants, children and adolescents. For all eligible studies, we judged the adequacy of the measurement properties and the methodological study quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results from different studies were summarized in a best-evidence synthesis and formed the basis to assign four degrees of recommendation. RESULTS Seventeen articles, three of which were found by hand search, were included. These 17 articles reported on 24 instruments. No instrument can be recommended for use in all eczema trials because none fulfilled all required adequacy criteria. With adequate internal consistency, reliability and hypothesis testing, the U.S. version of the Childhood Atopic Dermatitis Impact Scale (CADIS), a proxy-reported instrument, has the potential to be recommended depending on the results of further validation studies. All other instruments, including all self-reported ones, lacked significant validation data. CONCLUSIONS Currently, no QoL instrument for infants, children and adolescents with eczema can be highly recommended. Future validation research should primarily focus on the CADIS, but also attempt to broaden the evidence base for the validity of self-reported instruments.
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Affiliation(s)
- D Heinl
- Department of Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany
| | - C A C Prinsen
- VU University Medical Center, Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, Amsterdam, the Netherlands
| | - T Sach
- Norwich Medical School, University of East Anglia, Norwich, U.K
| | - A M Drucker
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, U.S.A
| | - R Ofenloch
- Department of Clinical Social Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - C Flohr
- St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - C Apfelbacher
- Department of Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Falmer, U.K
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