Department of General Practice, GRIAC Research Institute, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Clin Exp Allergy. 2012 Jul;42(7):1014-20. doi: 10.1111/j.1365-2222.2011.03927.x. Epub 2012 Jan 12.
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.
食物过敏已成为西方社会日益严重的健康问题。虽然食物过敏的死亡率相对较低，且几乎没有明显的身体症状，但食物过敏患者仍不断面临可能发生严重过敏反应的风险，以及需要严格注意饮食的必要性。健康相关生活质量（HRQL）可能是衡量食物过敏患者这种持续负担的唯一有意义的结果测量指标。HRQL 可以使用通用或特定疾病的工具进行测量。通用工具可能对健康状况的差异或变化反应相对不敏感，而特定疾病的工具通常对与特定疾病相关的相对微妙的问题更为敏感。最近，出现了一些特定于疾病的问卷，用于衡量食物过敏患者的 HRQL。进一步研究的一个重要领域是解释 HRQL 测量结果。在这方面，最小临床重要差异（MCID）特别值得关注。结合需要治疗的人数（NNT），这可以深入了解干预的临床相关性。由于目前还没有治愈食物过敏的方法，唯一可用的治疗方法是严格避免食用罪魁祸首食物，并提供紧急治疗。双盲安慰剂对照食物挑战（DBPCFC）被认为是诊断食物过敏的金标准。一些研究调查了接受 DBPCFC 的儿童的父母的看法。与父母的看法相反，对于接受 DBPCFC 的患者的看法，目前还有很多未知之处。除了研究食物过敏 HRQL 问卷的 MCID 和 NNT 外，进一步的研究还应集中在从食物过敏 HRQL 问卷中得出质量调整生命年（QALYs），以及在临床实践中在个体患者层面应用食物过敏 HRQL 问卷。
