What's in a Name: Atopic Dermatitis vs. Eczema
The issue of when to use eczema and when atopic dermatitis has thrown a wrench into data-mining machinations.
The term "atopic dermatitis (AD)" was found in a new meta-analysis to be used more than eczema in reports published in dermatology and allergy journals, while eczema was more commonly used in medicine and pediatrics journals.
The confusion of these and other descriptors such as atopic eczema has confounded data mining of electronic health records, resource access for patient literacy and education, the economics of diagnostic coding and reimbursement, and even the field of biomarker discovery and drug development, according to the investigators.
The systematic review and meta-analysis was published by Jonathon Silverberg, MD, PhD, Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Chicago, IL and colleagues in the October issue of Allergy. Atopic Dermatitis, Atopic Eczema, or Eczema? A Systematic Review, Meta-analysis, and Recommendation for Uniform Use of 'Atopic Dermatitis'
"We propose a concerted effort on the part of clinicians and scientists to avoid the use of the term eczema alone as a synonym for AD, whether in the scientific literature or patient education," Silverberg and colleagues declared.
The call for consensus by Silverberg and colleagues on the single term, atopic dermatitis, was joined in an accompanying editorial by Thomas Bieber, MD, PhD, Department of Dermatology and Allergy, University Medical Center, Bonn, Germany. Why We Need a Harmonized Name for Atopic Dermatitis/Atopic Eczema/Eczema!
While Bieber noted that the likely heterogeneity in pathophysiology could seem to warrant multiple terms, he suggested that a biomarker-based taxonomy will emerge, "for which we need an umbrella term such as atopic dermatitis.”
The meta-analysis revealed AD to be the most commonly used term overall, but with substantial variation across the literature. While AD was predominant in publications written in English, Japanese and Spanish, eczema was more common in those written in French, German, Italian and Russian. AD was more common in most types of reports, from clinical trials to comparative studies, but eczema was more commonly used in case reports.
Bieber offered another finding, from his review of the journal Allergy since 2012: While AD was used in more reports, atopic eczema was the term used in most reports on epidemiological issues, and assessment tools. The reports using the term atopic eczema, Bieber observed, "were typically written by scientists with expertise in epidemiology and data mining."
"Most physicians probably underestimate the important impact at different levels of the different names which have been coined for the most common skin disease," Bieber remarked.
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