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Guidelines for the Diagnosis and Management of Food Allergy in the United States

Literature Review and Ranking of Evidence

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What Is a Literature Review?

A literature review focuses on peer reviewed medical journals in a variety of databases, such as the MEDLINE database, the Cochrane Database of Systematic Reviews, the Cochrane Database of Abstracts of Reviews of Effects (DARE), the Cochrane Central Register of Controlled Trials (Central), and in other peer reviewed journals that may not be included in such databases.

When non-primary literature is used, it is accompanied by justification and reflected in the grading of the evidence. Non-primary literature is defined as review articles, meta-analyses, and data collected for other purposes or from other sources (i.e., industry surveys, compilations from computerized databases and information systems, and results from computerized or mathematical models).

Topics for the literature review are identified to guide the search, and limits on the age of articles searched may also be identified. The search for articles for the food allergy guidelines literature review was limited to articles published in 1988 and later.

The evidence can be reported in several forms. Evidence tables are prepared for selected topics and include detailed descriptions of identified studies. For topics that do not have a sufficient body of evidence or a sufficient number of high-quality studies, an evidence table is not generated. Narrative text is also used to summarize the findings and can give a qualitative analysis of the key questions and topic areas.

The data is evaluated and graded based on factors such as study relevance, bias, study design, study size, applicability to the majority population, and data quality. A report summarizing the state-of-the-science, including knowledge gaps and areas in which consensus has not been reached is the result of such a literature review.

Who Conducted the Literature Review for the Food Allergy Guidelines?

NIAID used an independent, systematic literature review and report on the state of science in food allergy, in conjunction with consensus expert opinion, to develop the Guidelines for the Diagnosis and Management of Food Allergy: Report of the NIAID-sponsored Expert Panel.

On September 26, 2008, NIAID awarded a contract to the RAND Corporation to conduct a systematic literature review and evidence based report on food allergy. Read more about the contractor conducting the literature review.

What Key Questions Were Used to Perform the Literature Review?

The key questions used to perform the literature review included

  • What is the definition of food allergy?
  • What are the incidence/prevalence of IgE-mediated food allergy and immunologic but non-IgE-mediated adverse reactions to food?
  • What are the symptoms and natural history of IgE-mediated and of immunologic but non-IgE-mediated adverse reactions to food?
  • What tools are currently used to diagnose IgE-mediated and non-IgE-mediated food allergies?
  • What methods are currently used to manage patients diagnosed with IgE-mediated food allergy?
  • What methods are currently used to manage patients diagnosed with non-IgE-mediated reactions to food, and how do they differ from methods used to manage patients diagnosed with IgE-mediated food allergy?
  • What are the appropriate methods of diagnosis and treatment of acute and life-threatening, IgE-mediated food allergic reactions?

A complete list of the questions used to perform the literature review is available as part of the final literature review. Read or download the literature review.

Last Updated February 16, 2012