Analyzing Studies: Per Protocol vs Intention to Treat

Should you avoid giving your child peanuts to ensure they don’t develop an allergy? If you’d asked medical authorities this question in the late 90s and early 2000s, you’d get an answer that’s completely opposite to what you’d get now.

In this episode of The Studies Show, Tom and Stuart discuss the science behind the medical recommendations on peanut allergy - the remarkable story of a major scientific U-turn.

The Studies Show is sponsored by Works in Progress magazine. Their latest article, about “advance market commitments” for vaccines and antibiotics and other stuff besides, is now available at worksinprogress.co.

Show notes

* Useful review article on the “diagnosis and management of food allergy”

* Analysis of UK NHS data on hospitalisations and mortality from anaphylaxis

* Two studies raising doubts about parents’ claims that their child has an allergy

* Recommendations on improving tests for food allergy

* 1998 UK Department of Health document recommending not to give children peanuts until 3 years of age

* 2000 American Academy of Pediatrics statement that broadly agrees

* Stuart’s 2023 i article on the controversy

* 2008 observational study comparing Jewish children in the UK (no peanuts) to Jewish children in Israel (lots of peanuts)

* …after which the advice in the UK is announced to be “suspended”

* The 2015 LEAP randomised controlled trial on peanut avoidance vs. peanut consumption in infants

* Follow-up of the same data to age 12

* BBC article about the follow-up

* Observational study from Australia finding no significant change in the prevalence of peanut allergy

* Paper arguing that if we want to see effects, we need to give peanuts to babies even earlier

* The EAT trial of food allergen exposure in non-high-risk infants

* Re-analysis of LEAP and EAT data to work out the best age to administer peanuts

* The PreventADALL study from Sweden

* 2019 article collecting examples of “medical reversals” from across the scientific literature

Credits

The Studies Show is produced by Julian Mayers at Yada Yada Productions.

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