*Full list of contributors:
Cezmi A. Akdis 13, Alberto Alvarez-Perea14, Montserrat Alvaro Lozano 15,
Riccardo Asero16, Barbara Ballmer-Weber17,18, Domingo Barber19,20, Simona
Barni21, Giovanni Battista Pajno22,
Kirsten Beyer23, Carsten
Bindslev-Jensen24, Helen Brough25,
26, 27, Betul Buyuktiryaki28, Lucila Camargo Lopes de
Oliveira29, Antonella Cianferoni30,
R Sharon Chinthrajah31,32, Stefano Del
Giacco33, Audrey DunnGalvin34,35,36,
Bernadette Eberlein37, Motohiro
Ebisawa38, Philippe Eigenmann39,
Thomas Eiwegger40,41,42, Margaretha
Faber43, Montserrat
Fernandez-Rivas44, Mary Feeney26,27,
Helen Fisher27, Mattia Giovannini45,
Susanne Halken46, Karin
Hoffmann-Sommergruber47, Hannah
Jaumdally27, Christina J Jones48,
Rebecca Knibb49, Edward Knol50,
George N Konstantinou51, Marta
Krawiec26,27, Susanne Lau52, Lina
Mayorga53, M. Andreina
Marques-Mejias26,27, Rosan Meyer54,
Beatriz Moya55, Charlotte G Mortz24,
Antonella Muraro56, Kari
Nadeau31,32, Caroline Nilsson57,58,
Liam O’Mahony59, Nikolaos G.
Papadopoulos60,61, Kirsten
Perrett62, Alexandre
Piletta-Zanin39, Marcia Podestà63,
Lars K. Poulsen64, Cristian Ricci1,
Graham Roberts65,66, Hugh Sampson67,
Sylwia Smolińska68, Jürgen
Schwarze69, Eva Untersmayr70, Ronald
Van Ree71, Carina Venter72, Brian P.
Vickery73, Berber Vlieg-Boerstra74
13 Swiss Institute of Allergy and Asthma Research
14 Hospital General Universitario Gregorio Marañón,
Madrid, Spain
15 Pediatric Allergy and Clinical Immunology Service,
Hospital Sant Joan de Déu, Barcelona
16 Clinica San Carlo, Paderno Dugnano, Italy
17 Allergy Unit, Department of Dermatology, University
Hospital of Zurich, Zurich, Switzerland; Faculty of Medicine, University
of Zurich, Zurich, Switzerland
18 Clinic for Dermatology and Allergology,
Kantonsspital St Gallen, St Gallen, Switzerland.
19 School of Medicine, Institute for Applied Molecular
Medicine (IMMA), Universidad CEU San Pablo, Madrid, Spain.
20 Instituto de Salud Carlos III, Madrid, Spain
21 Meyer Children’s University Hospital, Florence,
Italy
22 Pediatric Unit, Policlinico Hospital. University of
Messina-Italy
23 Charité Universitätsmedizin Berlin, Germany
24 Odense University Hospital, Odense Denmark
25 Evelina London Childrens Hospital, London, UK
26 Guy’s and St Thomas’ Hospital London, UK
27 King’s College London, UK
28 Koc University Hospital, Istanbul, Turkey
29 Federal University of São Paulo, Brazil
30 Department of Pediatrics, Division of Allergy and
Immunology, The Children’s Hospital of Philadelphia, PA, USA
31 Sean N Parker Center for Allergy and Asthma
Research, Stanford University, USA
32 Pulmonary, Allergy, Critical Care Medicine,
Department of Medicine, Stanford University, USA
33 Department of Medical Sciences and Public Health,
University of Cagliari, Italy
34 University College Cork, Ireland
35 Anaphylaxis Ireland (CEO)
36 Sechenov University,Moscow
37 Department of Dermatology and Allergy
BiedersteinTechnische Universität München
38 Department of Allergy, Clinical Research Center for
Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
39 University Hospitals of Geneva, Switzerland
40 The Hospital for Sick Children, Toronto, Ontario
41University of Toronto, Ontario
42University Hospital of St. Pölten, Karl Landsteiner
University of Health Sciences
43 University of Antwerp, Department of Immunology and
Allergology, Antwerp, Belgium
44 Allergy Dept., Hospital Clinico San Carlos,
Universidad Complutense, IdISSC, Madrid, Spain
45 Meyer Children’s University Hospital, Florence,
Italy
46 Hans Christian Andersen Children’s Hospital, Odense
University Hospital
47 Medical University of Vienna, Austria
48 University of Surrey, Guildford, UK
49 Department of Psychology, Aston University,
Birmingham, UK.
50 Departments of Immunology and
Dermatology/Allergology, University Medical Center Utrecht, Utrecht, the
Netherlands
51 Department of Allergy and Clinical Immunology
General Military Training Hospital, Thessaloniki, Greece
52 Universitaetsmedizin Berlin, Pediatric Respiratory
Medicine, Immunology and Intensive Care Medicine, Germany
53 Biomedical Research Institute and University
Hospital of Málaga
54 Imperial College London UK
55 Department of Allergy, Hospital Universitario 12 de
Octubre, Madrid, Spain
56 Food Allergy Referral Centre, Department of Woman
and Child Health, Padua University hospital , Padua , Italy
57 Department of Clinical Science and Education,
Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
58 Sachs’ Children and Youth Hospital, Södersjukhuset,
Stockholm, Sweden
59 University College Cork, Cork, Ireland
60 Allergy Department, 2nd Pediatric Clinic,
University of Athens, Greece
61 Division of Infection, Immunity & Respiratory
Medicine, University of Manchester, UK
62 Murdoch Children’s Research Institute, Melbourne,
Australia
63 European Federation of Allergy and Airways Diseases
Patient’s Associations, Belgium
64 Copenhagen University Hospital, Denmark
65 David Hide Centre, St Mary’s Hospital, Isle of
Wight, United Kingdom
66 University of Southampton, Southampton, United
Kingdom
67 Department of Pediatrics at the Icahn School of
Medicine at Mount Sinai
68 Wroclaw Medical University, Department of Clinical
Immunology, Wroclaw, Poland
69 The University of Edinburgh, Edinburgh, UK
70 Institute of Pathophysiology and Allergy Research,
Center for Pathophysiology, Infectiology and Immunology, Medical
University of Vienna
71 Amsterdam University Medical Centers, Location AMC,
The Netherlands
72 Children’s Hospital Colorado, University of
Colorado, Colorado, USA
73 Emory University and Children’s Healthcare of
Atlanta
74 OLVG Hospital, Amsterdam, the Netherlands
Conflict of interest statement: a separate COI form has been
submitted due to the long list of authors.
Abstract (237 words)
Background: The European Academy of Allergy and Clinical
Immunology (EAACI) is in the process of updating the guidelines on the
diagnosis and management of food allergy. The existing guidelines are
based on a systematic review of the literature until
30th September 2012. Therefore, a new systematic
review must be undertaken to inform the new guidelines. This systematic
review aims to assess the accuracy of index tests to support the
diagnosis of IgE-mediated food allergy.
Methods: The databases Cochrane CENTRAL (Trials), MEDLINE
(OVID) and Embase (OVID) will be searched for diagnostic test accuracy
studies from 1st October 2012 to
30th June 2021. Inclusion and exclusion criteria will
be used to select appropriate studies. Data from these studies will be
extracted and tabulated, and then reviewed for risk of bias and
applicability using the QUADAS-2 tool. All evaluation will be done in
duplicate. Studies with a high risk of bias and low applicability will
be excluded. Meta-analysis will be performed if there are three or more
studies of the same index test and food.
Results: A protocol for the systematic review and meta-analyses
is presented and was registered using Prospero prior to commencing the
literature search.
Discussion: Oral food challenges are the reference standard for
diagnosis but involve considerable risks and resources. This protocol
for systematic review aims to assess the accuracy of various tests to
diagnose food allergy, which can be useful in both clinical and research
settings.
Keywords: Food allergy, IgE-mediated, diagnosis, diagnostic
tests, specific IgE, skin prick test, component-resolved diagnostics,
basophil activation test, mast cell activation test
Key message: This is the protocol for the systematic review of
the literature which will inform the update of the Food Allergy
Guidelines of the European Academy of Allergy and Clinical Immunology
(EAACI).