Nut allergy guideline.

Abstract

In this issue of the Journal, we publish the British Society of Allergy and Clinical Immunology (BSACI) peanut and tree nut allergy guideline 1. So, I thought it would be timely to look at why we spend so much time developing and reading guidelines. If they are well generated, guidelines have the potential to improve the quality of clinical decision making and the care of our patients. A systematic review of the literature followed by a robust approach to assessing the quality of individual studies and synthesizing the available data into recommendations ought to provide an unbiased view of the literature and robust clinical advice. There is a limit to all of our individual clinical experience, particularly with less frequent presentations or when a novel study is published that really revolutionizes our understanding of a condition. An accessible, clinically relevant and user-friendly guideline can be very helpful to ensure we are all delivering the best quality medical care to our individual patients. Gary Stiefel Helene Lindvik Allergists will also be interested in another set of guidelines in generation by European Academy of Allergy and Clinical Immunology (EAACI). They focus on allergen immunotherapy covering prevention, food allergy, venom, rhinoconjunctivitis and asthma; other papers also focus on primary care and regulatory aspects. The process started 2 years ago and has led to the publication of a number of focused systematic reviews in Allergy and Pediatric Allergy and Immunology over the last year. The draft guidelines will be available for review for 3 weeks from 23 May 2017 at the following website: http://www.eaaci.org/resources/guidelines/ait-guidelines.html. As coordinator of the AIT Guidelines group, please can I invite you to review them and provide your feedback. Keeping on the peanut allergy theme, Lindvik et al. have evaluated whether conjunctival provocation testing might be a feasible, accurate and safe way of diagnosing peanut allergy 3. It is an interesting approach (Fig. 1), and it would be much simpler than an oral peanut challenge. Now, we need a larger pragmatic trial that compares this with the use of sensitization tests as well as challenges 4. Sarah El-Heis Anna Gref