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The HealthNuts population-based study of paediatric food allergy: validity, safety and acceptability
N J Osborne1, J J Koplin, P E Martin
1Gut and Liver, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
Insights
A food allergy study in Australia successfully recruited infants for allergy testing. While the sample represented the general population demographically, participants had lower peanut tolerance than non-participants.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Public Health Research
Background:
- Rising hospital admissions for food allergy-related anaphylaxis globally and in Australia.
- Lack of population-based data on food allergy prevalence and risk factors in Australia.
- Need for validated measures in food allergy research.
Purpose of the Study:
- To detail the methodology for recruiting infants for allergy assessments.
- To evaluate the representativeness of the study sample against the target population.
- To investigate potential biases using preliminary data and non-responder surveys.
Main Methods:
- Recruitment of 12-month-old infants at immunization clinics in Melbourne, Australia.
- Comparison of participant demographics with the Victorian Perinatal census database.
- Administration of a survey to non-participating families to assess potential biases.
Main Results:
- High community acceptance and recruitment rate (73.4%) with 2171 participants.
- Study population demographics closely mirrored the general Victorian population.
- Non-responders showed higher rates of peanut consumption and tolerance compared to participants.
Conclusions:
- The food allergy study achieved good community participation.
- The study sample demonstrated external validity in general demographics but differed in allergy history and peanut tolerance.
- Insights into internal validity were gained by analyzing differences between participants and non-responders.
Background:
The incidence of hospital admissions for food allergy-related anaphylaxis in Australia has increased, in line with world-wide trends. However, a valid measure of food allergy prevalence and risk factor data from a population-based study is still lacking.
Objective:
To describe the study design and methods used to recruit infants from a population for skin prick testing and oral food challenges, and the use of preliminary data to investigate the extent to which the study sample is representative of the target population.
Methods:
The study sampling frame design comprises 12-month-old infants presenting for routine scheduled vaccination at immunization clinics in Melbourne, Australia. We compared demographic features of participating families to population summary statistics from the Victorian Perinatal census database, and administered a survey to those non-responders who chose not to participate in the study.
Results:
Study design proved acceptable to the community with good uptake (response rate 73.4%), with 2171 participants recruited. Demographic information on the study population mirrored the Victorian population with most the population parameters measured falling within our confidence intervals (CI). Use of a non-responder questionnaire revealed that a higher proportion of infants who declined to participate (non-responders) were already eating and tolerating peanuts, than those agreeing to participate (54.4%; 95% CI 50.8, 58.0 vs. 27.4%; 95% CI 25.5, 29.3 among participants).
Conclusion:
A high proportion of individuals approached in a community setting participated in a food allergy study. The study population differed from the eligible sample in relation to family history of allergy and prior consumption and peanut tolerance, providing some insights into the internal validity of the sample. The study exhibited external validity on general demographics to all births in Victoria.
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