TABLE 1

Recent AD Management Guidelines

Methodology (Sponsoring Organization[s], Year)Evaluation CriteriaTreatment RecommendationsUtility
Diagnostic Criteria?Severity Evaluation?Algorithm?Severity-Based?Criteria to Step-Up/Down Treatment?UsabilityApplicability: Working Group Composition and/or Intended AudienceAccessibility
Composite of evidence with references for 9 AD management questions (AAD, 2004)4NoNoNoNoNoTreatment recommendations listed only in textFree from AAD, but not from journal
Level of evidence and consensus of opinion listed separately from recommendations
Guidelines “sunsetted” in 2009, but no new guidelines issued until 2014Working group included only dermatologists
Review of literature rated by category of evidence and strength of recommendation (ACAAI and AAAAI, 2004)5YesOnly for severeAnnotated linear management and treatment modelYesYesTreatment recommendations (with strength of recommendation) and algorithm details only listed in text“The evaluation and management of AD are…an integral part of an allergist/immunologist’s training and practice. It is also important for the PCP to understand the basis for effective evaluation and management…”Free from AAAAI and JTF but not from journal
Annotations and summary statements not integrated with algorithm
Review of literature (EAACI and AAAAI/PRACTALL, 2006)6YesNoStepwise treatment modelYes (but severity criteria not included)No (and no criteria for when to use topical corticosteroids ± TCI)Treatment and diagnosis recommendations listed only in textWorking group included allergists/immunologists and dermatologistsFree from 1 of 2 journals
No level of evidence indicated
Compilation of existing European evidence-based guidelines supplemented with new literature rated by grade of evidence and strength of recommendation (EDF, 2012)7,8Committee decided that guidelines should strictly concentrate on therapeutic regimens and omit sections on clinical diagnosisNoYesYesTreatment recommendations (with level of evidence and strength of recommendation) only listed in text“This guideline has been prepared for physicians, especially dermatologists, pediatricians, general practitioners and all specialists taking care of patients suffering from [AD]”Free from EDF and GAAPP, but not from journal
Provides guidance for monthly amounts of topical corticosteroids (in grams) and how to quantify topical therapy amounts (ie, FTU)
Review of literature rated by category of evidence and strength of recommendation (update of ACAAI and AAAAI 2004 Practice Parameter, 2012)9YesOnly for severeAnnotated linear management and treatment modelYesYesTreatment recommendations (with strength of recommendation) and algorithm details only listed in text as part of online supplement“The evaluation and management of AD are an integral part of an allergist/immunologist’s training and practice. It is also important for the PCP to understand the basis for effective evaluation and management…”Free from AAAAI, JTF, and journal (including online supplement)
Algorithm annotations and summary statements not integrated with algorithm“Cooperation between the patient and/or the patient's guardian or guardians, the PCP, and the allergist, dermatologist, or both is important in the implementation of strategies necessary for the care of patients with chronic AD… Even when an AD specialist is consulted, the PCP continues to play an important role in the care of patients with AD by ensuring continuity of care.”
In addition to allergists/immunologists, task force included psychologist and dermatologists
Recommendations rated by grade of evidence and strength of recommendation with references for 17 AD diagnosis and management questions (update of AAD 2004, AAD Guidelines, 2014)1013YesNoNoNoNoTreatment and diagnosis recommendations listed in tablesIn addition to dermatologists, working group included patient advocate and international representatives (Canada and UK)Free from AAD, but not from journal
Level of evidence and strength of recommendation listed separately from recommendations
Clinical questions that are new since last issuance indicated
  • AAAAI indicates American Academy of Allergy, Asthma and Immunology; AAD, American Academy of Dermatology; ACAAI, American College of Allergy, Asthma and Immunology; AD, atopic dermatitis; EAACI European Academy of Allergology and Clinical Immunology; EDF, European Dermatology Forum; FTU, fingertip unit; GAAPP, Global Allergy and Asthma Patient Platform; HCP, healthcare provider; JTF, AAAAI/ACAAI Joint Task Force on Practice Parameters; PRACTALL, Practical Allergy; PCP, primary care physician; TCI, topical calcineurin inhibitor.