Evidence-based and consented guideline on allergy prevention

Aktionsbündnis Allergieprävention , Luebeck

Allergies are a meaningful public-health problem. Until now, no evidence-based recommendations for allergy prevention exist. An evidence based guideline for primary and secondary prevention of allergies was developed in the course of the "Aktionsbündnis Allergieprävention” (abap; with a grant of the German Ministry of Health). Results of the systematic evidence search and the consented recommendations are presented here.

After an appropriate search strategy had been developed, a systematic literature search was performed in electronic databases (Cochrane library, MEDLINE, EMBASE). Furthermore four selected journals were hand-searched and reference lists of recent reviews as well as "grey literature" was screened. Some 3,500 references were retrieved initially, and a two-stage filter process on the relevance was applied by screening titles and abstracts and subsequently full-text papers. For the critical methodological appraisal, modifications of international checklists were used. A total of 323 studies were included and evaluated. These comprised 3 Cochrane Reviews, 7 meta-analyses, 36 randomized controlled trials (RCTs) as well as 102 cohort and 174 case-control-studies. The following levels of evidence were applied: 3x1a, 21x1b, 5x2a, 59x2b, 1x3a, 45x3b, 189x4. These studies were summarized in a form of a systematic review, and corresponding recommendations were formulated. The latter were consented by members of the abap steering committee in two consensus meetings, where the method of a nominal group process was applied. For the first time, recommendations for the prevention of allergies were developed on a high methodological standard. The content and modifications reflect the existing evidence.

Key words: guideline/ allergy/ prevention/ evidence/ evidence based medicine

Sie finden den Artikel in deutscher Sprache in Ernährungs-Umschau 09/04 ab Seite 361.

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