Differing methodological quality but identical recommendations? - Assessment of methodological quality and content analysis of Clinical Practice Guidelines and Food-based Dietary Guidelines in early childhood allergy prevention

Abstract

Objective Recommendations on early childhood allergy prevention (ECAP) are found in clinical practice guidelines (CPG) and food-based dietary guidelines (FBDG). This study aims to compare the methodological quality and the content of recommendations in CPGs and FBDGs for ECAP. Study Design and Setting We assessed methodological quality of a sample of 36 guidelines (23 CPGs, 13 FBDGs), retrieved through extensive searching, with the Appraisal of Guidelines for Research and Evaluation tool (AGREE) II. On a subset of recommendations, we performed an in-depth analysis by type of intervention for direction of and strength of recommendation and level of evidence. Descriptive analysis was conducted with SPSS 27. Results CPGs scored higher than FBDGs in most AGREE domains (3, 4, 5 and 6). The 36 guidelines contain 280 recommendations on ECAP, with 68 addressing the introduction of complementary foods and allergenic foods. We found only slight differences between those recommendations in CPGs and FBDGs. Conclusion FBDGs on ECAP are of lower quality than CPGs. This does not affect their recommendations on the introduction of complementary foods and allergenic foods but may compromise their trustworthiness.