Risk of eczema in children: a population-based study

Date of ISAC Approval: 
31/03/2016
Lay Summary: 
Eczema, a common skin disease, affects 20% of children in the UK and around 40% of the children continue to have this condition in adulthood. There is evidence that the number of children with eczema has increased in the last decades. However there is a lack of contemporary estimates of the risk of new cases of eczema in children in the UK. We therefore propose to examine the eczema risk by using routinely collected health information from the Clinical Practice Research Datalink. We will identify children with the onset of eczema under the age of 18 years from the general child population and assess the risk of onset over time and also by child's age, gender and other sociodemographic characters. Children with eczema are often prescribed multiple drugs to manage their condition and they can also develop other allergic conditions such as asthma and food allergy over time. Because of the high disease burden, the high drug prescription rate and the potential link with other allergic conditions, knowing the risk of new cases of eczema in children and how this has changed over time could yield substantial benefits for future health services planning and resource allocation.
Technical Summary: 
In the UK, contemporary estimates of eczema incidence in children are lacking and previous studies have shown inconsistent results due to different ways of measuring eczema. The aim of the project is therefore to assess the incidence of eczema in children in the UK. We will use the HES-linked CPRD records to establish an open cohort of children under the age of 18 years who have a first clinical diagnosis of eczema between April 1997 and March 2015. The study cases will be identified using various combinations of validated clinical diagnosis and treatments (including eczema-related drugs and phototherapy). Dr Abuabara is currently conducting a validation study of eczema diagnostic Read codes using data from The Health Improvement Network (SRC Reference Number: 14-083, Approved 15 January 2015, Study title: Eczema epidemiology and comorbidities). We will calculate crude incidence by dividing the number of cases by the total number of person-years from the HES-linked CPRD population at risk during the study period. We will calculate incidence stratified by age, sex, socioeconomic status, ethnicity and calendar year. We will also examine how the risk of eczema in children varies by calendar time, adjusted for age, sex, socioeconomic status and ethnicity.
Health Outcomes to be Measured: 
Incidence of eczema in children aged 0-17 years old
Collaborators: 

Dr Sonia Gran - Chief Investigator - University Of Nottingham
Dr Alyshah Abdul Sultan - Researcher - Astra Zeneca Ltd - UK Headquarters
Emma McManus - Researcher - University Of East Anglia
Dr Katrina Abuabara - Researcher - University Of California, San Francisco
Kim Thomas - Researcher - University Of Nottingham
Dr Lu Ban - Researcher - University Of Nottingham
Miriam Santer - Researcher - University Of Southampton
Sinead Langan - Researcher - London School Of Hygiene & Tropical Medicine (LSHTM)
Dr Sonia Gran - Corresponding Applicant - University Of Nottingham
Dr Tracey Sach - Researcher - University Of East Anglia

Linkages: 
HES Admitted;Patient IMD