1. British Association of Dermatologists National Clinical Audit Programme 2015: Atopic eczema in children (NICE CG57)

2. BAD-BSPD-NICE national audit on atopic eczema in children
Audit contributors
BAD and BSPD members, with some contributions from non-members and private providers
Leads
Drs Ali Al-Sharqi, David de Berker, M. Firouz Mohd Mustapa
Audit standards source
NICE clinical guidelines for the management of atopic eczema in children (CG57)
Completion date
March 2015
Number of contributors
128 submissions from 98 identifiable centres (including 6 private providers)
Number of patients
1264
n=128

3. Age distribution and breakdown of disease severity

4. Breakdown of treatment regimen by disease severity

5. Disease severity of patients receiving emollients with bandages, systemic and phototherapy

6. Audit standard: Provision of evidence-based information
34/46
72/169
28/50
89/170
85/134
19/40
28/59
44/70
42/70
24/40
60/120
15/38
99/180
61/78
n=1057
42/46
145/169
41/50
119/170
119/134
38/40
55/59
48/70
63/70
28/40
93/120
37/38
155/180
74/78
Boxplots: the national mean is denoted by the horizontal red line; regional sample medians are denoted by red dots with blue outline; lower or upper quartiles are denoted by ‘whiskers’; outliers are denoted by blue dots; high median values indicate widespread alignment with the standard; small interquartile ranges indicate little variation in practice within the region.
Boxplots representing the distributional mean percentage of “Yes” responses (n=700) and “Yes” with “Partial Yes” responses (n=1057) to having provided evidence-based information to each patient and/or carer, per hospital in each region.

7. Audit standard: Assessment of disease severity
19/46
121/169
28/50
100/170
105/134
16/40
39/59
54/70
46/70
22/40
73/120
27/38
118/180
49/78
n=1165
40/46
163/169
44/50
155/170
126/134
39/40
57/59
67/70
70/70
36/40
106/120
35/38
162/180
65/78
Boxplots representing the distributional mean percentage of “Yes” responses (n=817) and “Yes” with “Partial Yes” responses (n=1165) to having recorded assessment of disease severity for each patient at any visit, per hospital in each region.

8. Audit standard: Assessment of impact on quality of life
17/46
39/169
15/50
32/170
48/134
4/40
19/59
27/70
31/70
24/40
42/120
8/38
38/180
28/78
n=895
42/46
100/169
41/50
96/170
101/134
37/40
43/59
51/70
65/70
84/120
31/38
111/180
56/78
Boxplots representing the distributional mean percentage of “Yes” responses (n=372) and “Yes” with “Partial Yes” responses (n=895) to having recorded assessment of impact on quality of life for each patient at any visit, per hospital in each region.

9. Audit standard: Assessment of impact on psychosocial well-being
19/46
31/169
16/50
20/170
41/134
1/40
10/59
23/70
24/70
25/40
38/120
4/38
30/180
22/78
n=788
44/46
84/169
41/50
80/170
88/134
22/40
41/59
48/70
44/70
37/40
79/120
22/38
101/180
57/78
Boxplots representing the distributional mean percentage of “Yes” responses (n=304) and “Yes” with “Partial Yes” responses (n=788) to having recorded assessment of impact on psychosocial well-being for each patient at any visit, per hospital in each region.

10. Audit standard: Assessment of trigger factors at initial consultation
29/46
123/169
46/50
120/170
91/134
27/40
47/59
53/70
58/70
31/40
93/120
28/38
81/180
57/78
Boxplots representing the distributional mean percentage of “Yes” responses to having recorded assessment of trigger factors for each patient at initial consultation, per hospital in each region.

11. Audit standard: Management approach according to stepped-care plan
45/46
151/169
50/50
142/170
131/134
34/40
53/59
67/70
69/70
38/40
109/120
38/38
171/180
75/78
Boxplots representing the distributional mean percentage of “Yes” responses to having recorded a management approach according to the stepped-care plan, per hospital in each region.

12. Audit standard: Prescription of leave-on emollients (250-500 g weekly)
10/46
89/169
50/50
105/170
95/134
21/40
14/59
39/70
30/70
7/40
47/120
18/38
89/180
53/78
Boxplots representing the distributional mean percentage of “Yes” responses to having recorded prescription of leave-on emollients in quantities of g per week for each patient, per hospital in each region.

13. Audit standard: Moderate steroids on face and neck >5 days
44/46
134/169
34/50
105/170
106/134
38/40
55/59
61/70
65/70
32/40
84/120
35/38
158/180
52/78
Boxplots representing the distributional mean percentage of “No” responses to having recorded the use of moderate potency topical corticosteroids on the face and neck for more than 5 days between the last two visits for each patient, per hospital in each region.

14. Audit standard: Moderate/potent steroids on vulnerable areas >7-14 days
46/46
136/169
38/50
112/170
113/134
40/40
56/59
63/70
66/70
30/40
91/120
29/38
157/180
71/78
Boxplots representing the distributional mean percentage of “No” responses to having recorded the use of moderate or potent topical corticosteroids on vulnerable areas for more than 14 days between the last two visits for each patient, per hospital in each region.

15. Audit standard: Very potent steroids in the absence of specialist care
46/46
153/169
42/50
157/170
116/134
29/40
55/59
70/70
65/70
38/40
106/120
38/38
166/180
71/78
Boxplots representing the distributional mean percentage of “No” responses to having recorded the use of very potent topical corticosteroids in the absence of specialist care for each patient, per hospital in each region.

16. Audit standard: Appropriate referral
43/46
162/169
50/50
146/170
129/134
32/40
52/59
67/70
58/70
40/40
109/120
38/38
170/180
72/78
Boxplots representing the distributional mean percentage of “Yes” responses to having recorded an appropriate referral for each patient, per hospital in each region.

17. Audit standard: Late referral
40/46
148/169
46/50
141/170
120/134
30/40
51/59
63/70
52/70
31/40
94/120
35/38
138/180
71/78
Boxplots representing the distributional mean percentage of “No” responses to having recorded a late referral for each patient, per hospital in each region.

18. Audit standard: Availability of a range of unperfumed emollients