Incidence and sociodemographic characteristics of eczema diagnosis in children: A cohort study

Ban, Lu; Langan, Sinéad; Abuabara, Katrina; Kim, Thomas; Sultan, Alyshah Abdul; Sach, Tracey; McManus, Emma; Santer, Miriam; Ratib, Sonia

doi:10.1016/j.jaci.2017.12.997

Cited by 18 publications

(21 citation statements)

References 15 publications

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“…Individuals with eczema were identified using a validated algorithm developed for use with UK electronic health records 26 and applied in recent UK studies in eczema 15,16 . The positive predictive value of this algorithm is 90% (95% Confidence interval (CI) 80%–91%) in children and 82% (95% CI 73%–89%) in adults 26 .…”

Section: Methodsmentioning

confidence: 99%

The epidemiology of eczema in children and adults in England: A population‐based study using primary care data

Lusignan

Alexander

Broderick

et al. 2020

Clin Experimental Allergy

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Background Whilst eczema is a common inflammatory skin condition, we lack contemporary estimates of disease incidence and prevalence across the lifespan. Objective To estimate the incidence and prevalence of eczema in children and adults in England and variation by sociodemographic factors (sex, socio‐economic status, ethnicity, and geography). Methods We used the Royal College of General Practitioners Research and Surveillance Centre primary care research database of 3.85 million children and adults registered with participating general practitioner practices between 2009 and 2018 inclusive. Eczema incidence was defined as the first‐ever diagnosis of eczema recorded in the primary care record, and eczema prevalence was defined as fulfilment of criteria for active eczema (two eczema records appearing in the primary care record within any one‐year period). Results Eczema incidence was highest in infants younger than 1 year (15.0 per 100 person‐years), lowest in adults aged 40–49 (0.35 p/100 person‐years), and increased from middle age to a second smaller peak in people 80 years or older (0.79 p/100 person‐years). Eczema prevalence was highest in children aged 2 (16.5%) and lowest in adults aged 30–39 (2.8%). Eczema incidence was higher in male infants (<2) and male adults older than 70; for all other ages, incidence was higher in females. Eczema was more common in Asian and black ethnic groups than in people of white ethnicity. Higher socio‐economic status was associated with a greater incidence of eczema in infants younger than 2, but the reverse was seen for all other age groups. Both incidence and prevalence of eczema were greater in urban settings and in North‐West England. Conclusions and Clinical Relevance Eczema has a bimodal distribution across the lifespan. We observed differences in incidence and prevalence of eczema by ethnicity, geography, sex, and socio‐economic status, which varied in magnitude throughout life.

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Section: Methodsmentioning

confidence: 99%

The epidemiology of eczema in children and adults in England: A population‐based study using primary care data

Lusignan

Alexander

Broderick

et al. 2020

Clin Experimental Allergy

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“…The study will also be adequately powered to detect differences in the other primary outcome of interest (eczema) as incidence of clinician-diagnosed eczema is higher than asthma incidence in children in the UK 33–35…”

Section: Methods and Analysismentioning

confidence: 99%

Long-term impact of giving antibiotics before skin incision versus after cord clamping on children born by caesarean section: protocol for a longitudinal study based on UK electronic health records

et al. 2019

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IntroductionIn the UK, about a quarter of women give birth by caesarean section (CS) and are offered prophylactic broad-spectrum antibiotics to reduce the risk of maternal postpartum infection. In 2011, national guidance was changed from recommending antibiotics after the umbilical cord was cut to giving antibiotics prior to skin incision based on evidence that earlier administration reduces maternal infectious morbidity. Although antibiotics cross the placenta, there are no known short-term harms to the baby. This study aims to address the research gap on longer term impact of these antibiotics on child health.Methods and analysisA controlled interrupted time series study will use anonymised mother-baby linked routine electronic health records for children born during 2006–2018 recorded in UK primary care (The Health Improvement Network, THIN and Clinical Practice Research Datalink, CPRD) and secondary care (Hospital Episode Statistics, HES) databases. The primary outcomes of interest are asthma and eczema, two common allergy-related diseases in childhood. In-utero exposure to antibiotics immediately prior to CS will be compared with no exposure when given after cord clamping. The risk of outcomes in children delivered by CS will also be compared with a control cohort delivered vaginally to account for time effects. We will use all available data from THIN, CPRD and HES with estimated power of 80% and 90% to detect relative increase in risk of asthma of 16% and 18%, respectively at the 5% significance level.Ethics and disseminationEthical approval has been obtained from the University of Birmingham Ethical Review Committee with scientific approvals obtained from the independent scientific advisory committees from the Medicines and Healthcare products Regulatory Agency for CPRD and the data provider, IQVIA for THIN. The results will be published in peer-reviewed journals, presented at national and international conferences and disseminated to stakeholders.

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“…7 Another study reported AD incidence rates, but only in children. 8 Treatment AD treatment takes a multistep approach. Trigger avoidance and daily topical emollients form the mainstay of maintenance therapy.…”

Section: Current Knowledge Epidemiologymentioning

confidence: 99%

Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol

et al. 2020

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IntroductionAtopic dermatitis (AD) is one of the most common inflammatory skin conditions in both children and adults. Despite this, contemporary descriptions of the incidence, prevalence and current management of the condition in the UK are lacking.Methods and analysisWe will perform a series of retrospective studies using a large population-based cohort derived from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database to explore two key research themes: AD epidemiology and AD management.In the epidemiology theme, we will describe the incidence and prevalence of AD in children and adults in England from 2009 to 2018 inclusive. We will stratify findings by age, national Index of Multiple Deprivation (IMD), ethnicity, urban-rural environment and geographic location; and explore independent associations of these features with AD in multivariable models.In the management theme, we will explore healthcare utilisation and treatment in people with AD. Regarding healthcare utilisation, we will evaluate rates of AD-associated primary care visits and specialist dermatology referrals in people with AD. Rates will be stratified by age, gender, socioeconomic IMD quintile and ethnicity. We will describe contemporary treatment by estimating prescribing rates across medication classes used in AD (emollients, topical corticosteroids by potency, topical calcineurin inhibitors, topical antimicrobials, antihistamines, oral corticosteroids and systemic immunomodulatory therapies) overall, and by age and sociodemographic groupings. We will also examine trends in prescribing over the study period. In people first diagnosed with AD during the study period, we will describe differences in treatment escalation by sociodemographic factors using time-to-event analysis.Ethics and disseminationThe Health Research Authority decision tool classed this a study of ‘usual practice’, ethics approval was not required. Study approval was granted by the RCGP RSC Study Approval Committee. Results will be disseminated through peer-reviewed publications.Trial registration numberNCT03823794.

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Incidence and sociodemographic characteristics of eczema diagnosis in children: A cohort study

Cited by 18 publications

References 15 publications

The epidemiology of eczema in children and adults in England: A population‐based study using primary care data

The epidemiology of eczema in children and adults in England: A population‐based study using primary care data

Long-term impact of giving antibiotics before skin incision versus after cord clamping on children born by caesarean section: protocol for a longitudinal study based on UK electronic health records

Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol

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