Systematic review of atopic dermatitis disease definition in studies using routinely-collected health data

Abstract

Background

Routinely collected electronic health data (RCD) obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in RCD differ, and it is unknown how this might affect study results.

Objectives

We sought to evaluate how AD patients have been identified in studies using RCD, to determine whether these methods were validated, and to estimate how the method for identifying AD patients affected variability in prevalence estimates.

Methods

We systematically searched PubMed, EMBASE, and Web of Science for studies utilizing RCD that reported on AD as a primary outcome. Studies of localized AD and other types of dermatitis were excluded. The protocol for this review was registered in PROSPERO (CRD42016037968).

Results

59 studies met eligibility criteria. Medical diagnosis codes for inclusion and exclusion, number of occasions of a code, type of provider associated with a code, and prescription data were used to identify AD patients. Only two studies described validation of their methods and no study reported on disease severity. Prevalence estimates ranged from 0.18%-38.33% (median 4.91%) and up to 3-fold variation in prevalence was introduced by differences in the method for identifying AD patients.

Conclusions

This systematic review highlights the need for clear reporting of methods for identifying AD patients in routinely collected electronic health data to allow for meaningful interpretation and comparison of results.

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