Diagnosing and managing common food allergies: a systematic review.

摘要: Context There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to allergies. Objective To perform a systematic review of available evidence on prevalence, diagnosis, management, prevention Data Sources Electronic searches PubMed, Cochrane Database Systematic Reviews, Abstracts Reviews Effects, Central Register Controlled Trials. Searches were limited English-language articles indexed between January 1988 September 2009. Study Selection Diagnostic tests included if they had prospective, defined study population, used challenge as criterion standard, reported sufficient data calculate sensitivity specificity. reviews randomized controlled trials (RCTs) for outcomes also used. For foods where anaphylaxis common, cohort studies with sample size more than 100 participants included. Extraction Two investigators independently reviewed all titles abstracts identify potentially relevant resolved discrepancies by repeated discussion. Quality meta-analyses was assessed using AMSTAR criteria, quality QUADAS criteria allergy, RCTs Jadad criteria. Synthesis A total 12 378 citations identified 72 Food allergy affects 1% 2% less 10% population. It unclear increasing. Summary receiver operating characteristic curves comparing skin prick (area under curve [AUC], 0.87; 95% confidence interval [CI], 0.81-0.93) serum food-specific IgE (AUC, 0.84; CI, 0.78-0.91) showed statistical superiority either test. Elimination diets are mainstay therapy have been rarely studied. Immunotherapy promising insufficient recommend use. In high-risk infants, hydrolyzed formulas may prevent cow's milk standardized definitions high risk formula do not exist. Conclusion The greatly lack uniformity making diagnosis.