Project lead: Prof. Dr. Christian Apfelbacher PhD

Project member(s): Claudia Hasenpusch

Funding: DFG - Deutsche Forschungsgemeinschaft (German Research Foundation), 01.10.2019 - 31.05.2027

Early childhood allergy prevention (ECAP) is a dynamic field of health research. With the paradigm shift arising from the hygiene hypothesis, attributing the increase in asthma and allergies to a lack of infections and environmental exposures in childhood, we are currently experiencing a period in which evidence is emerging regarding new ways of preventing incident allergy.

Not all of the current findings on ECAP are yet part of allergy prevention guidelines. Thus, it is likely that there are gaps between what we know, from the best available research, and what happens in healthcare practice.

Non-reproducible or contradictory results in health research often lead to uncertainty among health professionals and the general public. That is why the methodology of evidence synthesis was developed using systematic reviews (SR). However, these - and consequently also clinical guidelines - quickly lose their relevance in fields of dynamic research such as early childhood allergy prevention (FKAP). It can therefore be assumed that there are gaps between knowledge from the best available evidence and actual ECAP practice. Continuously updated "living systematic reviews” (LSR) can narrow the gap between evidence and practice by keeping SRs continuously up to date.

The overall goal of this project is to develop an LSR of interventions for the prevention of allergies and allergic diseases in early childhood (0-3 years). The specific objectives of the project are 1) to identify ECAP interventions at the individual (e.g. early exposure to allergenic foods) as well as at the community level (e.g. programs to promote environmental diversity), 2) to summarize the evidence on the effectiveness and safety of the interventions, 3) assess the quality the the available evidence, 4) prepare summaries in plain language summaries (PLS) and, 5) develop a work-flow for the LSR.

During the first year a protocol for the SR will be developed and a systematic literature search will be carried out in order to identify suitable studies. In the second year, the main tasks are to extract data and to conduct (network) meta-analysis (NMA) and further, to prepare and to publish the base-line SR and PLS. In the third year, a corresponding web application will be developed to transform the SR into an LSR. An initial update of the literature research will be carried out and results and conclusions adjusted if necessary. As a result, the publication of new studies is continuously monitored and an ongoing peer-review process will be implemented to ensure a timely assessment of the risk of bias and the extraction of data from new studies. Available technologies will be used to assist in the LSR process (e.g. text mining, TaskEXchange).

This project will provide a comprehensive source of information on ECAP evidence. It  is closely linked to the project "Conflicts of Interest", since studies included in the SR or in guidelines can be compared. It is also linked to the projects "Health Professions" and "Digital Health Information", as these investigate how scientific evidence is used by health professions and represented in digital health information.

In addition, an extension of the project examines the evolving evidence base in terms of interventions aiming to improve pandemic COVID-19 health literacy (HL). Again, an LSR will provide a regularly updated summary of the evidence landscape. Because the COVID-19 pandemic is characterised by a rapidly emerging and changing evidence landscape, individuals have been faced with a wealth of dynamic and complex in-formation as well as increasing amounts of both valid as well as non-evidence based, incorrect or deliberately wrong information. Thus, the ability to find, understand, critically evaluate and apply COVID-19 pandemic-related information has become increasingly important. The tasks to be achieved include (i) the creation of a SR of all interventions with the aim of improving COVID-19 pandemic-related health literacy that have been carried out so far (baseline SR) and (ii) the transformation into a LSR. Further specific tasks correspond to the tasks listed above (2-5). The "WP 2-LSR-COVID-19" extension aims to provide researcher, scientists, health professionals, policy makers and the public with a living, synthesised evidence base from a growing number of studies on the effects of non-pharmacological interventions on pandemic HL during the COVID-19 pandemic.