B. M. J. Flokstra-de Blok

Health-related quality of life of food allergic patients: comparison with the general population and other diseases

To cite this article: Flokstra‐de Blok BMJ, Dubois AEJ, Vlieg‐Boerstra BJ, Oude Elberink JNG, Raat H, DunnGalvin A, Hourihane JO’B, Duiverman EJ. Health‐related quality of life of food allergic patients: comparison with the general population and other diseases. Allergy 2010; 65: 238–244.

Development and validation of a self-administered Food Allergy Quality of Life Questionnaire for children

Background Having a food allergy may affect health‐related quality of life (HRQL). Currently, no validated, self‐administered, disease‐specific HRQL questionnaire exists for children with food allergy.

Longitudinal validity and responsiveness of the Food Allergy Quality of Life Questionnaire - Parent Form in children 0-12 years following positive and negative food challenges.

Background There are no published studies of longitudinal health‐related quality of life (HRQL) assessments of food‐allergic children using a disease‐specific measure.

Development and validation of the Food Allergy Quality of Life Questionnaire – Adult Form

Background:  Health‐related quality of life (HRQL) may be affected by food allergy. Presently, no disease‐specific HRQL questionnaire exists for food allergic adults. Therefore, we developed and validated the Food Allergy Quality of Life Questionnaire – Adult Form (FAQLQ‐AF) in the Dutch language.

Health-related quality of life of food allergic patients measured with generic and disease-specific questionnaires.

To cite this article: Flokstra‐de Blok BMJ, van der Velde JL, Vlieg‐Boerstra BJ, Oude Elberink JNG, DunnGalvin A, Hourihane JO’B, Duiverman EJ, Dubois AEJ. Health‐related quality of life of food allergic patients measured with generic and disease‐specific questionnaires. Allergy 2010; 65: 1031–1038.

Development, validity and reliability of the food allergy independent measure (FAIM)

To cite this article: van der Velde JL, Flokstra‐de Blok BMJ, Vlieg‐Boerstra BJ, Oude Elberink JNG, DunnGalvin A, Hourihane JO’B, Duiverman EJ, Dubois AEJ. Development, validity and reliability of the food allergy independent measure (FAIM). Allergy 2010; 65: 630–635.

Parents report better health-related quality of life for their food-allergic children than children themselves.

Background Food allergy affects 5–6% of children and impairs health‐related quality of life (HRQL). Children and parents may differ in their views concerning the childs HRQL. In food allergy, child‐ and parent‐proxy‐reported HRQL have never been compared using valid disease‐specific instruments.

EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health‐related quality of life measures

Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunologys (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a systematic review of the literature on quality of life instruments for food allergy and the Appraisal of Guidelines for Research & Evaluation (AGREE II) guideline development process. Guidance is provided on the use of such instruments in research, and the current limitations of their use in clinical practice are described. Gaps in current knowledge as well as areas of future interest are also discussed. This document is relevant to healthcare workers dealing with food-allergic patients, scientists engaging in food allergy research and policy makers involved in regulatory aspects concerning food allergy and safety.

Quality of life measures for food allergy

Food allergy has become an emerging health problem in Western societies. Although food allergy is characterized by a relatively low mortality and an almost continual absence of physical symptoms, food allergic patients are continually confronted with the possibility of potentially severe reactions and the necessity of dietary vigilance. Health‐related quality of life (HRQL) may be the only meaningful outcome measure available for food allergy measuring this continuous burden. HRQL may be measured with generic or disease‐specific instruments. Generic instruments may be relatively unresponsive to differences or changes in health status, whereas disease‐specific instruments are generally more sensitive for relatively subtle problems related to a particular illness. Recently, a number of disease‐specific questionnaires have become available to measure the HRQL of food allergic patients. An important area for further research is the interpretation of the outcome of HRQL measures. In this respect, the minimal clinically important difference (MCID) is of special interest. In combination with the numbers needed to treat (NNT), this may give an ultimate insight into the clinical relevance of an intervention. Since there is still no cure for food allergy, the only available treatment is strict avoidance of the culprit food and provision of emergency treatment. The double‐blind placebo‐controlled food challenge (DBPCFC) is considered to be the gold standard for diagnosing food allergy. A number of studies have investigated the perceptions of parents whose children underwent a DBPCFC. In contrast to the parental perception, there is much currently still unknown about the effects of undergoing a DBPCFC in the perceptions of patients. In addition to the research on MCID and NNT of food allergy HRQL questionnaires, further research should focus on deriving quality‐adjusted life years (QALYs) from food allergy HRQL questionnaires and the application of food allergy HRQL questionnaires at the individual patient level in clinical practice.

Disease-specific health-related quality of life instruments for IgE-mediated food allergy

This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are significantly more sensitive than generic ones in measuring the response to interventions or future treatments, as well as estimating the general burden of food allergy. The aim of this systematic review was therefore to identify which disease-specific, validated instruments can be employed to enable assessment of the impact of, and investigations and interventions for, IgE-mediated food allergy on health-related quality of life (HRQL). Using a sensitive search strategy, we searched seven electronic bibliographic databases to identify disease-specific quality of life (QOL) tools relating to IgE-mediated food allergy. From the 17 eligible studies, we identified seven disease-specific HRQL instruments, which were then subjected to detailed quality appraisal. This revealed that these instruments have undergone formal development and validation processes, and have robust psychometric properties, and therefore provide a robust means of establishing the impact of food allergy on QOL. Suitable instruments are now available for use in children, adolescents, parents/caregivers, and adults. Further work must continue to develop a clinical minimal important difference for food allergy and for making these instruments available in a wider range of European languages.