Eczema is a common childhood condition where the skin is dry and itchy. Most children with eczema are diagnosed and looked after in primary care. Treating eczema can be a challenge and affect the whole family's quality of life. Where eczema symptoms prove difficult to manage, parents/carers often look to find a 'cure' by eliminating foods, on the suspicion of a food allergy.
Food allergies can cause immediate or delayed reactions. Immediate reactions are generally easy to diagnose, whereas delayed reactions causing 'only' eczematous reactions, for example, are more difficult to pick-up. Arguments in favour of allergy testing include the observation that food allergy tests are more likely to be positive in childen with eczema and that for some children their eczema appears to improve on an elimination diet. Arguments against allergy testing include the fact that positive tests do not necessarily mean the child has an allergy to that food, and for many, their eczema persists regardless of any changes to the diet. In addition, allergy tests are costly and may cause unnecessary food elimination.
TEST Study Summary
Our research question is "What is the clinical (disease severity) and cost-effectiveness of routine food allergy testing plus advice compared to current standard practice for the management of eczema in children?"
The TEST Study aims to answer this question by recruiting 80 children between 3 months and 5 years, with eczema and no medically diagnosed food allergy. The 80 children will be randomly allocated to the intervention test group (allergy test with structured allergy history) or usual care test group.
The main outcome will be to determine how feasible it would be to conduct a clinical trial on a larger scale.
A nested qualitative study, where we talk to GPs and parents/carers of children with eczema, will allow us to understand their views on the value of allergy testing in primary care.