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Li T, Zheng Q, Zhang M, Li Y, Zhou Y, Xu C, Zhang B, Wang Z, Tian J, Zhou L. How consistent are the key recommendations, and what is the quality of guidelines and expert consensus regarding paediatric cow's milk protein allergy? Eur J Pediatr 2024; 183:3543-3556. [PMID: 38809454 DOI: 10.1007/s00431-024-05622-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/10/2024] [Accepted: 05/19/2024] [Indexed: 05/30/2024]
Abstract
The objective of this study was to assess the quality and consistency of recommendations in clinical practice guidelines (CPGs) and expert consensus on paediatric cow's milk protein allergy (CMPA) to serve as a foundation for future revisions and enhancements of clinical guidelines and consensus documents. We conducted a comprehensive literature search across several databases, including the Chinese Biomedical Literature Database (CBM), PubMed, Embase, Web of Science, UpToDate, ClinicalKey, DynaMed Plus and BMJ Best Practice. We spanned the search period from the inception of each database through October 1, 2023. We integrated subject headings (MeSH/Emtree) and keywords into the search strategy, used the search methodologies of existing literature and developed it in collaboration with a librarian. Two trained researchers independently conducted the literature screening and data extraction. We evaluated methodological quality and recommendations by using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and AGREE-Recommendations for Excellence (AGREE-REX) tools. Moreover, we compared and summarized key recommendations from high-quality CPGs. Our study included 27 CPGs and expert consensus documents on CMPA. Only four CPGs (14.8%) achieved a high-quality AGREE II rating. The four high-quality CPGs consistently provided recommendations for CMPA. The highest scoring domains for AGREE II were 'scope and purpose' (77 ± 12%) and 'clarity of presentation' (75 ± 22%). The lowest scoring domains were 'stakeholder involvement' (49 ± 21%), 'rigor of development' (34 ± 20%) and 'applicability' (12 ± 20%). Evaluation with AGREE-REX generally demonstrated low scores across its domains. Conclusion: Recommendations within high-quality CPGs for the paediatric CMPA showed fundamental consistency. Nevertheless, the methodology and recommendation content of CPGs and the expert consensus exhibited low quality, thus indicating a substantial scope for enhancement. Guideline developers should rigorously follow the AGREE II and AGREE-REX standards in creating CPGs or expert consensuses to guarantee their clinical efficacy in managing paediatric CMPA. What is Known: • The quality of clinical practice guidelines and expert consensus on paediatric cow's milk protein allergy (CMPA) remains uncertain. • There is a lack of clarity regarding the consistency of crucial recommendations for CMPA management. What is New: • Improving the methodological quality of guidelines and consensus on CMPA requires greater emphasis on stakeholder engagement, rigorous development processes, and practical applicability. • The recommendations from four high-quality guidelines align. However, addressing clinical applicability, integrating values and preferences, and ensuring actionable implementation are critical to improving the quality of all guidelines.
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Affiliation(s)
- Tengfei Li
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qingyong Zheng
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Mingyue Zhang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yiyi Li
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yongjia Zhou
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Caihua Xu
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Bowa Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Zewei Wang
- First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
| | - Li Zhou
- Department of Gastroenterology, Gansu Province Maternity and Child Health Hospital (Gansu Province Central Hospital), Lanzhou, China.
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2
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Trepanier L, Hébert C, Stamoulos C, Reyes A, MacIntosh H, Beauchamp S, Larivée S, Dagenais C, Drapeau M. The quality of four psychology practice guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE) II. J Eval Clin Pract 2022; 28:1138-1146. [PMID: 35599434 DOI: 10.1111/jep.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Clinical Practice Guidelines (CPGs) have been shown to improve healthcare services and clinical outcomes. However, they are useful resources only to the degree that they are developed according to the most rigorous standards. Multiple studies have demonstrated significant variability between CPGs with regard to specific indicators of quality. The Ordre des psychologues du Québec (OPQ), the College of psychologists of Quebec, has published several CPGs that are intended to provide empirically supported guidance for psychologists in the areas of assessment, diagnosis, general functioning, treatment and other decision-making support. The aim of this study was to evaluate the quality of these CPGs. METHODS The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the quality of the CPGs. RESULTS Our results show that although there have been some modest improvements in quality of the CPGs over time, there are important methodological inadequacies in all CPGs evaluated. CONCLUSIONS The findings of this study demonstrate the need for more methodological rigour in CPGs development as such, recommendations to improve CPG quality are discussed.
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Affiliation(s)
- Lyane Trepanier
- Department of Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Catherine Hébert
- Department of Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | | | - Andrea Reyes
- Department of Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | | | - Sylvie Beauchamp
- Department of Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Direction des affaires universitaires, de l'enseignement et de la recherche, Montreal West Island Integrated University Health and Social Services Center, Montreal, Quebec, Canada
| | - Serge Larivée
- School of Psychoeducation, University of Montreal, Montreal, Quebec, Canada
| | - Christian Dagenais
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Martin Drapeau
- Department of Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines update – IV – A quality appraisal with the AGREE II instrument. World Allergy Organ J 2022; 15:100613. [PMID: 36091188 PMCID: PMC9419447 DOI: 10.1016/j.waojou.2021.100613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/20/2021] [Accepted: 11/05/2021] [Indexed: 01/02/2023] Open
Abstract
Background Since the publication of The World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines in 2010, a number of other guidelines, expert opinions, and position papers relating to the management of cow's milk allergy (CMA) have been published. We aimed to systematically review the quality of the guidelines on CMA diagnosis and management in children and/or adults published between 2010 and 2020. Methods The MEDLINE, EMBASE, ISI Web of Science, World Health Organization Global Index Medicus, and Turning Research into Practice databases as well as website guideline repositories were searched from January 2010 until May 2020. Any clinical practice recommendations and/or guidelines focusing on the diagnosis and management of CMA in children and/or adults developed or endorsed by professional scientific societies or organizations were included. The guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool, a 23-item tool organized within 6 domains and 2 global rating items. Results We included 12 guidelines; 8 were developed by national and 4 by international organizations. The quality scores for each domain varied: of all domains, the clarity of presentation domain had the highest median score (92%; Q1-Q3 81–100%), whereas rigor of development had the lowest median score (30%; Q1-Q3 15–67%). The median scores (Q1-Q3) for individual domains were as follows: scope and purpose 82% (70–99%), stakeholder involvement 63% (21–79%), rigor of development 30% (15–67%), clarity of presentation 92% (81–100%), applicability 68% (57–75%), and editorial independence 75% (69–100%). The median overall score was 70% (58–89%). Only 1 guideline (from the National Institute for Health and Care Excellence [NICE]) achieved top ratings (100%) in five domains and the overall score. Three guidelines (from the NICE, the British Society for Allergy & Clinical Immunology [BSACI] and WAO) achieved the highest ratings (100%) in at least 3 domains and the overall score. Conclusion The majority of identified guidelines were of good or very good quality. However, the weakest point was the rigor of development domain, mostly due to unclear description of strengths and limitations of the body of evidence and the procedure for updating the guidelines.
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Fiocchi A, Bognanni A, Brożek J, Ebisawa M, Schünemann H. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - I - Plan and definitions. World Allergy Organ J 2022; 15:100609. [PMID: 35145603 PMCID: PMC8818560 DOI: 10.1016/j.waojou.2021.100609] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/08/2021] [Accepted: 11/04/2021] [Indexed: 12/12/2022] Open
Abstract
Since the World Allergy Organization (WAO) Diagnosis and Rationale against Cow's Milk Allergy (DRACMA) Guidelines were published 10 years ago, new evidence has accumulated about the diagnosis, therapy, and specific immunotherapy for cow's milk allergy (CMA). For this reason, WAO has felt the need to update the guidelines. We introduce here this update. The new DRACMA guidelines aim to comprehensively address the guidance on diagnosis and therapy of both IgE non-IgE-mediated forms of cow's milk allergy in children and adults. They will be divided into 18 chapters, each of which will be dedicated to an aspect. The focus will be on the meta-analyzes and recommendations that will be expressed for the 3 most relevant clinical aspects: (a) the diagnostic identification of the condition; (b) the choice of the replacement formula in case of CMA in infancy when the mother is not able to breastfeed, and (c) the use of specific immunotherapy for cow's milk protein allergy.
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Affiliation(s)
- Alessandro Fiocchi
- Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Bognanni
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Jan Brożek
- Department of Medicine, Division of Clinical Immunology and Allergy, Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Hamilton, ON, Canada
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Holger Schünemann
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
- Cochrane Canada and McMaster GRADE Centre, Hamilton, Ontario, Canada
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Effects of Cow's Milk Components, Goat's Milk and Sheep's Milk Sensitivities on Clinical Findings, and Tolerance Development in Cow's Milk Allergy. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:391-397. [PMID: 34712082 PMCID: PMC8526229 DOI: 10.14744/semb.2020.90688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
Objective: Cow’s milk (CM) contains some proteins capable of causing an allergic reaction in a sensitized individual and one of the most common causes of food allergy in childhood. Most of the patients will develop tolerance by the age of 3. In this study, we aimed to evaluate sensitivity to CM allergen components as well as goat’s milk (GM) and sheep’s milk cross reactions in cow’s milk allergic (CMA) patients and to figure out the risk factors for tolerance non-development. Methods: This is a retrospective cross-sectional study including 66 patients for IgE-mediated CMA with mean age of 38 months. We evaluated the patients in two groups: Group 1 (n=50): Patients who have no tolerance in oral food challenge test; Group 2 (n= 16): Patients who were found tolerant to CM after elimination diet. Cow’s milk-spesific IgE(sIgE), α-lactalbumin(ALA)-sIgE, β-Lactoglobulin(BLG)-sIgE, casein-sIgE, goat’s milk-sIgE, sheep’s milk-sIgE, skin prick tests(SPTs) with CM and GM, eosinophils in peripheral blood were all compared between two groups. Results: In the whole group, goat’s milk-sIgE and sheep’s milk-sIgE were positive in 84.8% and ALA-sIgE, BLG-sIgE, casein-sIgE were positive in 69.7%, 62.7%, 77.3% of the patients, respectively. Two groups were similar in terms of age at onset and diagnosis, gender, median elimination period, total IgE levels, cow’s milk-sIgE and eosinophilia (p>0.05). Mean wheal diameters of CM and GM in SPT (p<0.001), goat’s milk-sIgE (p=0.03), sheep’s milk-sIgE (p=0.01) were significantly higher in Group 1. Cow’s milk-sIgE showed a positive correlation with total IgE (p=0.001), eosinophilia percentage (p=0.04), CM wheal diameter in SPT (p=0.001), casein-sIgE (p<0.001), goat’s milk-sIgE (p<0.001), sheep’s milk-sIgE (p<0.001) in Group 1. Patients with respiratory symptoms and history of anaphylaxis had higher cow’s milk-SPT, cow’s milk-sIgE, casein-sIgE, goat’s milk-sIgE, sheep’s milk-sIgE levels(p<0.05). Gastrointestinal and skin symptoms showed no relation with laboratory findings. Any patient with a history of anaphylaxis did not develop tolerance. Conclusions: As with cow’s milk-sIgE levels and high induration diameters in SPT; high casein-sIgE, sheep’s milk-sIgE and goat’s milk-sIgE levels are also risk factors for persistence of CMA. Anaphylaxis, as a first reaction, may also be a risk factor. High cow’s milk-sIgE, casein-sIgE, sheep’s milk-sIgE, goat’s milk-sIgE levels are associated with respiratory symptoms.
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6
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Pajno GB, Szajewska H. Cow's milk allergy guidelines promote over-diagnosis of cow's milk disease. Allergy 2021; 76:1929-1931. [PMID: 33382106 DOI: 10.1111/all.14729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Giovanni B. Pajno
- Department of Human Pathology in Adult and Development Age Pediatric Unit University of Messina Messina Italy
| | - Hania Szajewska
- Department of Paediatrics The Medical University of Warsaw Warsaw Poland
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Dovigi E, Lee I, Tejasvi T. Evaluation of Teledermatology Practice Guidelines and Recommendations for Improvement. Telemed J E Health 2021; 28:115-120. [DOI: 10.1089/tmj.2021.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Edwin Dovigi
- Department of Dermatology, Rush University Medical Center, Chicago, Illinois, USA
| | - Ivy Lee
- Pasadena Premier Dermatology, Pasadena, California, USA
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
- Dermatology Service, Ann Arbor VA Medical Center, Ann Arbor, Michigan, USA
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Toca M, Roman-Riechmann E, Vázquez-Frías R, Batista de Morais M, Sosa P, Boggio-Marzet C, Becker D, Delgado L, Marchisone S. A Latin American pediatric gastroenterology group’s understanding of cow’s milk protein allergy diagnosis and treatment: Results of a survey by the Food Allergy Working Group of the Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2020. [DOI: 10.1016/j.rgmxen.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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9
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Toca MC, Roman-Riechmann E, Vázquez-Frías R, Batista de Morais M, Sosa P, Boggio-Marzet C, Becker D, Delgado L, Marchisone S. A Latin American and Spanish pediatric gastroenterology group's understanding of cow's milk protein allergy diagnosis and treatment: Results of a survey by the Food Allergy Working Group of the Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2020; 85:382-389. [PMID: 31623948 DOI: 10.1016/j.rgmx.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/17/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION There are discrepancies in the diagnosis and management of cow's milk protein allergy (CMPA) in Spain and Latin America. The aim of the present study was to find out how Spanish and Latin American pediatric gastroenterologists diagnose and treat CMPA. MATERIAL AND METHODS Pediatric gastroenterologists, members of the Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición, were invited to fill out a structured survey, the results of which were then compared with the 2012 and 2014 diagnosis and treatment guidelines, respectively. RESULTS The survey results showed that 17% of the participants follow the diagnostic recommendations based on the published consensus and guidelines. To diagnose non-IgE-mediated CMPA, 15% of the participants utilize IgE-specific skin prick tests, 22% use IgE-specific blood tests, and 45% employ oral food challenges. To diagnose IgE-mediated CMPA the percentages for the same diagnostic methods were 57, 83 and 22%, respectively. Once diagnosis is confirmed, 98% of the participants provide dietary recommendations. In children that are not breastfed, 89% of the participants prescribe an initial extensively hydrolyzed formula, 9% an amino acid formula, 1% a soy formula, and 1% a hydrolyzed rice formula. In patients with IgE-mediated CMPA, 34% of the participants carry out an oral challenge once treatment is completed, 39% according to symptom severity, and 27% in relation to IgE-specific testing. CONCLUSION CMPA management is diverse and there is poor adherence to the clinical practice guidelines.
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Affiliation(s)
- M C Toca
- Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | - E Roman-Riechmann
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España
| | - R Vázquez-Frías
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
| | - M Batista de Morais
- Escuela Paulista de Medicina, Universidade Federal de Sáo Paulo, Sao Paulo, Brasil
| | - P Sosa
- Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | - C Boggio-Marzet
- Departamento Materno Infanto Juvenil, Hospital General de Agudos Dr. Ignacio Pirovano, Buenos Aires, Argentina
| | - D Becker
- Ministerio de Salud Pública y Bienestar Social del Paraguay, Asunción, Paraguay
| | - L Delgado
- Centro Hospitalario Pereira Rossel, Montevideo, Uruguay
| | - S Marchisone
- Hospital Infantil de Córdoba, Córdoba, Argentina
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Vieira SCF, Santos VS, Franco JM, Nascimento-Filho HM, Barbosa KDOESS, Lyra-Junior DPD, Bastos KDA, Cipolotti R, Wayhs MLC, Vieira MC, Solé D, de Morais MB, Gurgel RQ. Brazilian pediatricians' adherence to food allergy guidelines-A cross-sectional study. PLoS One 2020; 15:e0229356. [PMID: 32092100 PMCID: PMC7039437 DOI: 10.1371/journal.pone.0229356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022] Open
Abstract
Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (≥80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.
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Affiliation(s)
- Sarah Cristina Fontes Vieira
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Jackeline Motta Franco
- Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | | | | | - Kleyton de Andrade Bastos
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Rosana Cipolotti
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Mônica Lisboa Chang Wayhs
- Department of Pediatrics, Federal University of Santa Catarina, Florianópolis-Santa Catarina, Brazil
| | - Mário César Vieira
- Center for Pediatric Gastroenterology, Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.,Department of Pediatrics, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Dirceu Solé
- Department of Pediatrics, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Ricardo Queiroz Gurgel
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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Sun Y, Chen J, Shi SZ, Ge L, Bu YX, Xi JB, Tian JH. Are paediatric clinical practice guidelines trustworthy? J Paediatr Child Health 2019; 55:1044-1055. [PMID: 31350939 DOI: 10.1111/jpc.14567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess the methodological and reporting quality of paediatric clinical practice guidelines (CPGs) in National Guideline Clearinghouse (NGC) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) standard. METHODS We identified all published CPGs through the NGC, and search records were screened in duplicate for inclusion. Two researchers evaluated the methodological and reporting quality of paediatric CPGs using the AGREE II instrument and RIGHT standard. STATA version 12.0 and SPSS version 22.0 software were used to analyse the related data. RESULTS A total of 50 paediatric CPGs were included. The scores for all six domains by AGREE II instrument were presented as follows: scope and purpose (85.6 ± 9.59), stakeholder involvement (69.15 ± 19.32), rigour of development (73.19 ± 17.18), clarity of presentation (78.51 ± 14.36), applicability (54.61 ± 22.63) and editorial independence (68.42 ± 13.06). In the seven domains of the RIGHT standard, the reporting rate of the recommendation domain was the lowest (52.86%).The highest reporting rate was the other information domain, which was 68%.There was a high correlation between reporting the completeness of CPGs using the AGREE II instrument and RIGHT standard (r = 0.77, P < 0.001). CONCLUSIONS The paediatric CPGs from NGC have good quality. There was a high correlation in the completeness of reporting for paediatric CPGs using the AGREE II instrument and RIGHT standard. It could be concluded that the CPGs of good methodological quality have good reporting quality. Maybe the researcher should effectively combine the AGREE II instrument and RIGHT standard in the development process of CPGs.
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Affiliation(s)
- Yue Sun
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
| | - Ji Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
| | - Shu-Zhen Shi
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
| | - Long Ge
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China.,The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - You-Xiang Bu
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
| | - Jiang-Bo Xi
- School of Geological Engineering and Geomatics, Chang'an University, Xi'an, China
| | - Jin-Hui Tian
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
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12
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Trajanovska M, King S, Goldfeld S, Gibb S. A novel method of rapid appraisal of clinical practice guidelines for children with enuresis. J Pediatr Urol 2019; 15:333.e1-333.e9. [PMID: 31217085 DOI: 10.1016/j.jpurol.2019.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/16/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Enuresis (bedwetting) is a common but variably managed pediatric condition. Despite an abundance of published documents which provide recommendations for clinical evaluation and management of enuresis, no formal appraisal of their methodological quality has been undertaken. OBJECTIVE The objective of the study is to evaluate the quality of current pediatric guidelines for enuresis (bedwetting) using a novel method of appraisal. STUDY DESIGN A comprehensive gray literature search was undertaken to identify guideline documents that provided recommendations for management of enuresis in children and adolescents. The search strategy included guideline databases, targeted websites, Google search engines, and MEDLINE. Guideline documents included clinical practice guidelines, consensus documents, position statements, and other clinical review documents. Each document underwent basic appraisal by two independent assessors using the International Centre for Allied Health Evidence (iCAHE) Guideline Quality Checklist. Those documents which (1) had an iCAHE quality score of ≥10; (2) used a systematic search strategy; and (3) linked evidence to their recommendations underwent further detailed appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. RESULTS Eighteen documents were shortlisted for basic appraisal. The iCAHE highlighted a lack of information regarding underlying evidence and dates (mean score 36% and 41%, respectively). Only three documents met basic quality criteria and progressed to detailed appraisal using the AGREE II. These included guidelines produced by the Paediatric Society of New Zealand and National Clinical Guideline Centre and a position statement from the Canadian Paediatric Society. All three guidelines presented clear and unambiguous recommendations (mean score 80%). However, information regarding stakeholder involvement was lacking (mean score 50%). CONCLUSIONS Several guidelines exist for the evaluation and management of children with enuresis, but many lack appropriate methodological quality standards. The guideline produced by the National Clinical Guideline Centre achieved the highest quality rating and is recommended for future adaptation and implementation in relevant clinical settings.
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Affiliation(s)
- M Trajanovska
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia 3052
| | - S King
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - S Goldfeld
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia 3052; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, 3052, Australia; Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia
| | - S Gibb
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, 3052, Australia.
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13
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Chong V, Schultz TJ, Donnelly F. Clinical protocols for adults with acute abdominal pain in Australian emergency departments. J Eval Clin Pract 2019; 25:412-419. [PMID: 30714279 DOI: 10.1111/jep.13103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/29/2018] [Accepted: 01/03/2019] [Indexed: 12/20/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Patients with acute abdominal pain are a common presentation in hospital emergency departments; however, international studies have demonstrated that hospitals often lack clinical protocols to guide care. This study aimed to investigate whether Australian hospital emergency departments have acute abdominal pain clinical protocols, identify hospital-level predictors of the presence of these clinical protocols, and assess the quality of protocols. METHODS A survey was sent to all Australian hospitals with emergency departments, collecting data on hospital characteristics and the presence of acute abdominal pain clinical protocols. Participating hospitals (n = 73, 26% response rate) were also asked to provide a copy of these protocols. The quality of these protocols was assessed using Appraisal of Guidelines for REsearch & Evaluation (AGREE) II. RESULTS Slightly more than half (n = 40) of the hospitals surveyed had acute abdominal pain clinical protocols, while 16 had a general pain protocol. In binomial logistic regression, two independent variables were related to the presence of a protocol, geographic region (P = 0.008) and advanced practice nurses/nurse practitioners' presence on staff (P = 0.024). The mean score for the overall quality assessment of these protocols was 4.2 on a seven-point Likert scale; in terms of the six domains of quality, "Clarity of presentation" and "Scope and purpose" were highest. The overall quality of clinical protocols increased with remoteness, χ2 (3) = 8.341, P = 0.039, and was lower in hospitals with medical staff on site (U = 2.5, P = 0.007). CONCLUSION There is a documented standard for pain management of acute abdominal pain in about three quarters of participating Australian emergency departments. The use and quality of clinical protocols is influenced by the physical location of hospitals and staff and skill mix of clinicians.
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Affiliation(s)
- Vivienne Chong
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Timothy J Schultz
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
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14
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Paparo L, Nocerino R, Bruno C, Di Scala C, Cosenza L, Bedogni G, Di Costanzo M, Mennini M, D'Argenio V, Salvatore F, Berni Canani R. Randomized controlled trial on the influence of dietary intervention on epigenetic mechanisms in children with cow's milk allergy: the EPICMA study. Sci Rep 2019; 9:2828. [PMID: 30808949 PMCID: PMC6391485 DOI: 10.1038/s41598-019-38738-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/09/2019] [Indexed: 12/17/2022] Open
Abstract
Epigenetic mechanisms could drive the disease course of cow’s milk allergy (CMA) and formula choice could modulate these pathways. We compared the effect of two different dietary approaches on epigenetic mechanisms in CMA children. Randomized controlled trial on IgE-mediated CMA children receiving a 12-month treatment with extensively hydrolyzed casein formula containing the probiotic L.rhamnosus GG (EHCF + LGG) or with soy formula (SF). At the baseline, after 6 and 12 months of treatment FoxP3 methylation rate and its expression in CD4+ T cells were assessed. At same study points IL-4, IL-5, IL-10, and IFN-γ methylation rate, expression and serum concentration, miRNAs expression were also investigated. 20 children (10/group) were evaluated. Baseline demographic, clinical and epigenetic features were similar in the two study groups. At 6 and 12 months, EHCF + LGG group showed a significant increase in FoxP3 demethylation rate compared to SF group. At the same study points, EHCF + LGG group presented a higher increase in IL-4 and IL-5 and a higher reduction in IL-10 and IFN-γ DNA methylation rate compared to SF group. A different modulation of miR-155, -146a, -128 and -193a expression was observed in EHCF + LGG vs. SF. Dietary intervention could exert a different epigenetic modulation on the immune system in CMA children.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Giorgio Bedogni
- Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
| | | | | | - Valeria D'Argenio
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University Federico II, Naples, Italy.,Task Force on Microbiome Studies, University Federico II, Naples, Italy
| | - Francesco Salvatore
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University Federico II, Naples, Italy.,Task Force on Microbiome Studies, University Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy. .,CEINGE-Biotecnologie Avanzate s.c.ar.l., University Federico II, Naples, Italy. .,European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy. .,Task Force on Microbiome Studies, University Federico II, Naples, Italy.
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15
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Nutrition guidelines vary widely in methodological quality: an overview of reviews. J Clin Epidemiol 2018; 104:62-72. [DOI: 10.1016/j.jclinepi.2018.08.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/25/2018] [Accepted: 08/22/2018] [Indexed: 12/15/2022]
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16
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Roberts G. A call to arms. Clin Exp Allergy 2018; 46:1134-5. [PMID: 27574039 DOI: 10.1111/cea.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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17
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Dahdah L, Fierro V, Mennini M, Arasi S, Fiocchi A. What’s next for DRACMA? Expert Rev Clin Immunol 2018; 14:649-651. [DOI: 10.1080/1744666x.2018.1500900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lamia Dahdah
- Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City
| | - Vincenzo Fierro
- Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City
| | - Maurizio Mennini
- Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City
| | - Stefania Arasi
- Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City
| | - Alessandro Fiocchi
- Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Vatican City
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18
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Meyer R, Groetch M, Venter C. When Should Infants with Cow's Milk Protein Allergy Use an Amino Acid Formula? A Practical Guide. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:383-399. [DOI: 10.1016/j.jaip.2017.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/04/2017] [Accepted: 09/16/2017] [Indexed: 12/18/2022]
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19
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Fiocchi A, Schunemann H, Ansotegui I, Assa’ad A, Bahna S, Canani RB, Bozzola M, Dahdah L, Dupont C, Ebisawa M, Galli E, Li H, Kamenwa R, Lack G, Martelli A, Pawankar R, Said M, Sánchez-Borges M, Sampson H, Shamir R, Spergel J, Terracciano L, Vandenplas Y, Venter C, Waserman S, Wong G, Brozek J. The global impact of the DRACMA guidelines cow's milk allergy clinical practice. World Allergy Organ J 2018; 11:2. [PMID: 29308116 PMCID: PMC5753480 DOI: 10.1186/s40413-017-0179-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/06/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The 2010 Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines are the only Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines for cow's milk allergy (CMA). They indicate oral food challenge (OFC) as the reference test for diagnosis, and suggest the choice of specific alternative formula in different clinical conditions. Their recommendations are flexible, both in diagnosis and in treatment. OBJECTIVES & METHODS Using the Scopus citation records, we evaluated the influence of the DRACMA guidelines on milk allergy literature. We also reviewed their impact on successive food allergy and CMA guidelines at national and international level. We describe some economic consequences of their application. RESULTS DRACMA are the most cited CMA guidelines, and the second cited guidelines on food allergy. Many subsequent guidelines took stock of DRACMA's metanalyses adapting recommendations to the local context. Some of these chose not to consider OFC as an absolute requirement for the diagnosis of CMA. Studies on their implementation show that in this case, the treatment costs may increase and there is a risk of overdiagnosis. Interestingly, we observed a reduction in the cost of alternative formulas following the publication of the DRACMA guidelines. CONCLUSIONS DRACMA reconciled international differences in the diagnosis and management of CMA. They promoted a cultural debate, improved clinician's knowledge of CMA, improved the quality of diagnosis and care, reduced inappropriate practices, fostered the efficient use of resources, empowered patients, and influenced some public policies. The accruing evidence on diagnosis and treatment of CMA necessitates their update in the near future.
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Affiliation(s)
- Alessandro Fiocchi
- Division of Allergy, Department of Pediatrics, Pediatric Hospital Bambino Gesù, Piazza Sant’Onofrio, Vatican City, Rome Italy
| | - Holger Schunemann
- Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
| | - Ignacio Ansotegui
- Department of Allergy & Immunology, Hospital Quironsalud Bizkaia, Carretera Leioa-Unbe 33 bis, 48950 Erandio - Bilbao, Spain
| | - Amal Assa’ad
- Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Sami Bahna
- Pediatrics & Medicine, Allergy & Immunology, Louisiana State University Health Sciences Center, Shreveport, LA USA
| | - Roberto Berni Canani
- Department of Translational Medical Science, European Laboratory for Investigation of Food Induced Diseases and CEINGE Advanced Biotechnology, University of Naples Federico II, Naples, Italy
| | - Martin Bozzola
- Department of Pediatrics, British Hospital, Perdriel 74, CABA, Buenos Aires, Argentina
| | - Lamia Dahdah
- Division of Allergy, Department of Pediatrics, Pediatric Hospital Bambino Gesù, Piazza Sant’Onofrio, Vatican City, Rome Italy
| | - Christophe Dupont
- Department of Pediatric Gastroenterology Hepatology and Nutrition, Hôpital Necker Enfants Malades, Paris, France
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa Japan
| | - Elena Galli
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy
| | - Haiqi Li
- Pediatric Division, Department of Primary Child Care, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Rose Kamenwa
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya
| | - Gideon Lack
- King’s College London, Asthma-UK Centre in Allergic Mechanisms of Asthma, Department of Paediatric Allergy, St Thomas’ Hospital, London, UK
| | | | - Ruby Pawankar
- Department of Otolaryngology, Nippon Medical School, 1-1-5 Sendagi, Tokyo, 113 Japan
| | - Maria Said
- Allergy & Anaphylaxis Australia (A&AA) organisation, Sydney, Australia
| | - Mario Sánchez-Borges
- Department of Allergy and Clinical Immunology Centro Médico-Docente La Trinidad Caracas, Caracas, Venezuela
| | - Hugh Sampson
- Department of Pediatrics, Jaffe Food Allergy Institute, New York, USA
- Icahn School of Medicine at Mount Sinai, Box 1089, New York, USA
| | - Raanan Shamir
- Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children’s Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan Spergel
- Division of Allergy and Immunology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA USA
| | - Luigi Terracciano
- National Pediatric Healthcare System, Board member of the Italian Pediatric Respiratory Society, ATS, Milan, Italy
| | - Yvan Vandenplas
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Carina Venter
- Section of Allergy & Immunology, University of Colorado Denver School of Medicine | Children’s Hospital Colorado, Aurora, CO USA
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - Gary Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Jan Brozek
- Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada
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20
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Roberts G, Boyle R, Crane J, Hogan SP, Saglani S, Wickman M, Woodfolk JA. Developments in the field of allergy in 2016 through the eyes of Clinical and Experimental Allergy. Clin Exp Allergy 2017; 47:1512-1525. [PMID: 29068551 DOI: 10.1111/cea.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2016. Experimental models of allergic disease, basic mechanisms, clinical mechanisms, allergens, asthma and rhinitis, and clinical allergy are all covered.
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Affiliation(s)
- G Roberts
- Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - R Boyle
- Department of Paediatrics, Imperial College London, London, UK
| | - J Crane
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - S P Hogan
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - S Saglani
- National Heart & Lung Institute, Imperial College London, London, UK
| | - M Wickman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - J A Woodfolk
- Division of Asthma, Allergy and Immunology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
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21
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Fuller TE, Haider HF, Kikidis D, Lapira A, Mazurek B, Norena A, Rabau S, Lardinois R, Cederroth CR, Edvall NK, Brueggemann PG, Rosing SN, Kapandais A, Lungaard D, Hoare DJ, Cima RFF. Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults. Front Psychol 2017; 8:206. [PMID: 28275357 PMCID: PMC5319986 DOI: 10.3389/fpsyg.2017.00206] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/01/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe.
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Affiliation(s)
- Thomas E. Fuller
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
- Adelante, Centre of Expertise in Rehabilitation and AudiologyHoensbroek, Netherlands
| | - Haula F. Haider
- ENT Department of Hospital, Cuf Infante Santo - Nova Medical SchoolLisbon, Portugal
| | - Dimitris Kikidis
- Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General HospitalAthens, Greece
| | - Alec Lapira
- ENT Specialist, Institute of Health Care, Mater Dei HospitalMalta, Malta
| | - Birgit Mazurek
- Tinnitus Center, Charite University HospitalBerlin, Germany
| | - Arnaud Norena
- Laboratory of Adaptive and Integrative Neuroscience, Centre National de la Recherche Scientifique, Fédération de Recherche, Aix-Marseille UniversitéMarseille, France
| | - Sarah Rabau
- Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of AntwerpAntwerp, Belgium
| | - Rachelle Lardinois
- Adelante, Centre of Expertise in Rehabilitation and AudiologyHoensbroek, Netherlands
| | | | - Niklas K. Edvall
- Department of Physiology and Pharmacology, Karolinska InstitutetStockholm, Sweden
| | | | - Susanne N. Rosing
- Department of Clinical Research, Faculty of Health Sciences, University of Southern DenmarkOdense, Denmark
| | - Anestis Kapandais
- Department of Nordic Studies and Linguistics, Copenhagen UniversityDenmark
| | - Dorte Lungaard
- Department of Clinical Research, Faculty of Health Sciences, University of Southern DenmarkOdense, Denmark
| | - Derek J. Hoare
- NIHR Nottingham Hearing Biomedical Research Unit, Division of Clinical Neuroscience, School of Medicine, University of NottinghamNottingham, UK
| | - Rilana F. F Cima
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
- Adelante, Centre of Expertise in Rehabilitation and AudiologyHoensbroek, Netherlands
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