What is "high risk?" a systematic review of atopy risk and implications for primary prevention

Area of Science:

• Pediatrics
• Allergy and Immunology
• Public Health

Background:

• Atopic diseases, such as asthma and eczema, are increasingly prevalent worldwide.
• Primary prevention strategies focus on identifying and intervening in high-risk children.
• Existing methods for identifying high-risk children in atopy prevention studies lack standardization.

Purpose of the Study:

• To evaluate the diverse methodologies employed to identify high-risk children within atopy prevention research.
• To assess the commonalities and variations in risk identification techniques used in published studies.

Main Methods:

• A comprehensive literature search was conducted for studies published between 1986 and 2006.
• Abstracts were screened, followed by a detailed review of selected articles.
• Fifty-seven studies met the inclusion criteria for analysis of risk identification methods.

Main Results:

• Thirty distinct methods were identified for defining high risk in children.
• Family history of atopy was the most frequently used predictor.
• Only a minority of studies utilized validated questionnaires for family history assessment; others relied solely on reported history.

Conclusions:

• The current approaches to identifying children at high risk for atopic diseases are inconsistent.
• There is a significant need for the development and implementation of a practical, validated screening tool for early identification.