Individual participant data meta‐analysis versus aggregate data meta‐analysis: A case study in eczema and food allergy prevention

Vogt, Eleanor Van; Cro, Suzie; Cornelius, Victoria; Williams, Hywel C; Askie, Lisa; Phillips, Rachel; Kelleher, Maeve; Boyle, Robert

doi:10.1111/cea.14085

Cited by 8 publications

(3 citation statements)

References 24 publications

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“…Aggregate data made up only 2% of total included participants. We have also replicated the IPD review using published aggregate data only, and the results were consistent with no intervention effect 6 Kataoka 2010, Thitiiwong 2019 and Bellemere 2018 did not contribute data to our primary outcome meta‐analysis, because the timing of outcome assessment was not eligible according to our predefined protocol and statistical analysis plan.…”

Section: No Of Participants Zhong Ma Cochrane Ipd Review Primary Outc...mentioning

confidence: 52%

Correspondence to " Emollients in infancy to prevent atopic dermatitis: A systematic review and meta‐analysis"

Kelleher

Cro

Phillips

et al. 2022

Allergy

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Section: No Of Participants Zhong Ma Cochrane Ipd Review Primary Outc...mentioning

confidence: 52%

Correspondence to " Emollients in infancy to prevent atopic dermatitis: A systematic review and meta‐analysis"

Kelleher

Cro

Phillips

et al. 2022

Allergy

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“…Further IPD analysis may be helpful for better understanding adverse effect data and subgroup analyses but is unlikely to have a significant effect on the efficacy outcomes. Our data represent clinical trial populations and may therefore lack generalizability. In Australia, population-based studies demonstrated a shift to earlier peanut and egg introduction since 2016 but no reduction in peanut allergy associated with this shift.…”

Section: Discussionmentioning

confidence: 99%

Timing of Allergenic Food Introduction and Risk of Immunoglobulin E–Mediated Food Allergy

et al. 2023

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ImportanceEarlier egg and peanut introduction probably reduces risk of egg and peanut allergy, respectively, but it is uncertain whether food allergy as a whole can be prevented using earlier allergenic food introduction.ObjectiveTo investigate associations between timing of allergenic food introduction to the infant diet and risk of food allergy.Data SourcesIn this systematic review and meta-analysis, Medline, Embase, and CENTRAL databases were searched for articles from database inception to December 29, 2022. Search terms included infant, randomized controlled trial, and terms for common allergenic foods and allergic outcomes.Study SelectionRandomized clinical trials evaluating age at allergenic food introduction (milk, egg, fish, shellfish, tree nuts, wheat, peanuts, and soya) during infancy and immunoglobulin E (IgE)–mediated food allergy from 1 to 5 years of age were included. Screening was conducted independently by multiple authors.Data Extraction and SynthesisThe Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Data were extracted in duplicate and synthesized using a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was used to assess certainty of evidence.Main Outcomes and MeasuresPrimary outcomes were risk of IgE-mediated allergy to any food from 1 to 5 years of age and withdrawal from the intervention. Secondary outcomes included allergy to specific foods.ResultsOf 9283 titles screened, data were extracted from 23 eligible trials (56 articles, 13 794 randomized participants). There was moderate-certainty evidence from 4 trials (3295 participants) that introduction of multiple allergenic foods from 2 to 12 months of age (median age, 3-4 months) was associated with reduced risk of food allergy (risk ratio [RR], 0.49; 95% CI, 0.33-0.74; I2 = 49%). Absolute risk difference for a population with 5% incidence of food allergy was −26 cases (95% CI, −34 to −13 cases) per 1000 population. There was moderate-certainty evidence from 5 trials (4703 participants) that introduction of multiple allergenic foods from 2 to 12 months of age was associated with increased withdrawal from the intervention (RR, 2.29; 95% CI, 1.45-3.63; I2 = 89%). Absolute risk difference for a population with 20% withdrawal from the intervention was 258 cases (95% CI, 90-526 cases) per 1000 population. There was high-certainty evidence from 9 trials (4811 participants) that introduction of egg from 3 to 6 months of age was associated with reduced risk of egg allergy (RR, 0.60; 95% CI, 0.46-0.77; I2 = 0%) and high-certainty evidence from 4 trials (3796 participants) that introduction of peanut from 3 to 10 months of age was associated with reduced risk of peanut allergy (RR, 0.31; 95% CI, 0.19-0.51; I2 = 21%). Evidence for timing of introduction of cow’s milk and risk of cow’s milk allergy was very low certainty.Conclusions and RelevanceIn this systematic review and meta-analysis, earlier introduction of multiple allergenic foods in the first year of life was associated with lower risk of developing food allergy but a high rate of withdrawal from the intervention. Further work is needed to develop allergenic food interventions that are safe and acceptable for infants and their families.

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“…In this issue, Van Vogt, Cro and colleagues, representing the Skincare interventions for the prevention of atopic dermatitis (SCiPAD) collaboration leadership, report a comparison of aggregate MA vs IPD MA of skin care interventions, primarily moisturizers (emollients), vs standard care for the prevention of atopic dermatitis and IgE‐mediated food allergy in infants 2 . Smartly planned, excellently done, spectacularly interpreted and impactfully informative, they report similar effect estimates using both analytic approaches, and the IPD approach better addressed the between‐study heterogeneity, allowed more sophisticated statistical analyses and could reduce research waste.…”

Section: Characteristic Aggregate Ma Ipd Mamentioning

confidence: 99%

Individual‐patient data and aggregate evidence syntheses and the future of allergy‐immunology research

Chu

2022

Clin Experimental Allergy

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Individual participant data meta‐analysis versus aggregate data meta‐analysis: A case study in eczema and food allergy prevention

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 8 publications

References 24 publications

Correspondence to " Emollients in infancy to prevent atopic dermatitis: A systematic review and meta‐analysis"

Correspondence to " Emollients in infancy to prevent atopic dermatitis: A systematic review and meta‐analysis"

Timing of Allergenic Food Introduction and Risk of Immunoglobulin E–Mediated Food Allergy

Individual‐patient data and aggregate evidence syntheses and the future of allergy‐immunology research

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