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Protocol for a case-control diagnostic accuracy study to develop diagnostic criteria for psoriasis in children
Esther Burden-Teh1, Ruth Murphy2, Sonia Gran2
1Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK esther.burden-teh@nottingham.ac.uk.
Insights
Developing new diagnostic criteria for pediatric psoriasis is crucial for timely treatment. This study aims to create history and examination-based criteria to accurately distinguish childhood psoriasis from other scaly rashes.
Area of Science:
- Dermatology
- Pediatric Medicine
- Clinical Diagnostics
Background:
- Diagnosing psoriasis in children presents significant challenges.
- Early and accurate diagnosis is vital for appropriate treatment and monitoring of pediatric psoriasis.
- Psoriasis in children carries substantial physical, psychological, and quality-of-life burdens.
Purpose of the Study:
- To develop clinical examination and history-based diagnostic criteria for psoriasis in children.
- To differentiate pediatric psoriasis from other inflammatory scaly skin conditions.
- To improve diagnostic accuracy and facilitate timely management of childhood psoriasis.
Main Methods:
- A consensus study with international psoriasis experts informed the initial criteria development.
- Children with psoriasis (cases) and other scaly inflammatory skin diseases (controls) were recruited.
- Diagnostic criteria were assessed by blinded investigators, with dermatologist diagnosis serving as the reference standard.
- Multivariate logistic regression will be used to identify the best predictive criteria.
Main Results:
- Sensitivity and specificity of the consensus-derived criteria will be calculated.
- The study aims to identify the most predictive diagnostic criteria for pediatric psoriasis.
- Results will be based on a comparison between the developed criteria and dermatologist diagnoses.
Conclusions:
- The developed diagnostic criteria aim to aid clinicians in accurately identifying psoriasis in children.
- Improved diagnostic tools can lead to earlier intervention and better management of pediatric psoriasis.
- This research seeks to reduce the diagnostic delay and associated burdens for children with psoriasis.
Introduction:
Diagnosing psoriasis in children can be challenging. Early and accurate diagnosis is important to ensure patients receive psoriasis specific treatment and monitoring. It is recognised that the physical, psychological, quality of life, financial and comorbid burden of psoriasis are significant. The aim of this study is to develop clinical examination and history-based diagnostic criteria for psoriasis in children to help differentiate psoriasis from other scaly inflammatory rashes. The criteria tested in this study were developed through a consensus study with a group of international psoriasis experts (International Psoriasis Council).
Methods And Analysis:
Children and young people (<18 years) with psoriasis (cases) and other scaly inflammatory skin diseases (controls) diagnosed by a dermatologist are eligible for recruitment. All participants complete a single research visit including a diagnostic criteria assessment by a trained investigator blinded to the participant's diagnosis. The reference standard of a dermatologist's diagnosis is extracted from the medical record. Sensitivity and specificity of the consensus derived diagnostic criteria will be calculated and the best predictive criteria developed using multivariate logistic regression.
Ethics And Dissemination:
Health Regulatory Authority and National Health Service Research Ethics Committee approvals were granted in February 2017 (REC Ref: 17/EM/0035). Dissemination will be guided by stakeholders; patients, children and young people, dermatologists, primary care and paediatric rheumatologists. The aim is to publish the study results in a high-quality peer-reviewed journal, present the findings at international academic meetings and disseminate more widely through social media and working with patient associations.
Trial Registration Number:
ISRCTN98851260.
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