Guideline fever: an overview of DRACMA, US NIAID and UK NICE guidelines

It is well known that many aspects of food allergy are lacking sufficient research and publication. Practising evidence-based medicine in this field is, therefore, a particular challenge. Internationally, there is considerable variation in practices and no agreed treatment pathways. The time was right to review the evidence and seek the views of experts in the field, industry and food allergic individuals to develop guidance for clinical practice and to plan future research. The purpose of this review was to summarize points of agreement and discrepancy in the recently published Diagnosis and Rationale for Action against Cow's Milk Allergy, US NIAID and UK NICE guidelines.

The publication of the three guideline documents on food allergies gives clinicians, scientists, industry, governments and patients the opportunity to review the information in a concise format and appreciate the role of clinical expertise in decision making. The guidelines covered all aspects of food allergy: prevalence and natural history, diagnosis, management and treatment and other aspects such as vaccinations.

The guidelines summarized not only our current evidence base but also gaps in our knowledge. Use of these guidelines would facilitate high quality standardized care and indicate the direction of future research.