KEY CLINICAL QUESTION 3

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REVIEW QUESTION 3Which diagnostic tools and strategy are most appropriate and accurate to diagnose IgE-mediated food allergy in children?
OBJECTIVESTo determine whether test accuracy varies within subgroups of the population.
To determine whether threshold values for diagnostic tests differ within subgroups of the population.
To determine whether diagnostic tools have differing acceptability within subgroups of the population.
CRITERIA FOR CONSIDERING STUDIESAll study designs (no restrictions)
POPULATIONChildren (under 18 years) presenting with symptoms of food allergy separated in the following sub-groups;
Those with existing atopic diseases
Those with a first degree relative with a food allergy or other atopic disease
Age specific groups (0-6months, 6months-1year, 1-2years, 2-5years, 5-10years and 10-18years)
DIAGNOSTIC TOOLSkin Prick Test (SPT) using fresh or commercial extracts
Serum Specific IgE tests
Elimination diet
Atopy Patch Test (APT)
Vega test/Applied kinesiology/Hair analysis/Leucocytotoxic test/IgG test
Other diagnostic tests
APT is experimental in diagnosing IgE reactions.
COMPARATORSDouble Blind Placebo Controlled Food Challenge (DBPCFC)NB: Not appropriate for all age groups and may not be used within primary care (need to consider).
OUTCOMESUtility of various tools for the correct diagnosis and assessment of IgE-mediated food allergy in children Diagnostic accuracy of diagnostic tools
Threshold values of diagnostic tools for the correct diagnosis of IgE-mediated food allergy in children Acceptability of diagnostic strategies to age-specific subgroups
Adverse events associated with diagnostic tools Health related quality of life associated with diagnostic tools in primary care and community settings
Resource use and costs

From: Appendix 1.1, Review protocol

Cover of Food Allergy in Children and Young People
Food Allergy in Children and Young People: Diagnosis and Assessment of Food Allergy in Children and Young People in Primary Care and Community Settings.
NICE Clinical Guidelines, No. 116.
Centre for Clinical Practice at NICE (UK).
Copyright © 2011, National Institute for Health and Clinical Excellence.

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