Tham, Elizabeth HuiwenLeung, Agnes Sze YinYamamoto-Hanada, KiwakoDahdah, LamiaTrikamjee, ThuljaWarad, Vrushali VijayNorris, MatthewNavarrete, ElsyLevina, DariaSamuel, MinyVan Niekerk, AndreMartinez, SantiagoEllis, Anne K.Bielory, LeonardVan Bever, HugoWallace, DanaChu, Derek K.Munblit, DanielTang, Mimi L.K.Sublett, JamesWong, Gary Wing Kin2023-10-242023-10-242023-04Tham, E.H., Leung, A.S.Y., Yamamoto-Hanada, K. et al. (2023) ‘A systematic review of quality and consistency of clinical practice guidelines on the primary prevention of food allergy and atopic dermatitis’, World Allergy Organization Journal, 16(4), p. 100770. doi:10.1016/j.waojou.2023.100770.1939-4551 (print)10.1016/j.waojou.2023.100770http://hdl.handle.net/2263/93034BACKGROUND AND AIMS : With an increasing number of Clinical Practice Guidelines (CPGs) addressing primary prevention of food allergy and atopic dermatitis, it is timely to undertake a comprehensive assessment of the quality and consistency of recommendations and evaluation of their implementability in different geographical settings. METHODS : We systematically reviewed CPGs from 8 international databases and extensive website searches. Seven reviewers screened records in any language and then used the AGREE II and AGREE REX instruments to critically appraise CPGs published between January 2011 and April 2022. RESULTS : Our search identified 2138 relevant articles, of which 30 CPGs were eventually included. Eight (27%) CPGs were shortlisted based on our predefined quality criteria of achieving scores >70% in the “Scope and Purpose” and “Rigour of Development” domains of the AGREE II instrument. Among the shortlisted CPGs, scores on the “Applicability” domain were generally low, and only 3 CPGs rated highly in the “Implementability” domain of AGREE-REX, suggesting that the majority of CPGs fared poorly on global applicability. Recommendations on maternal diet and complementary feeding in infants were mostly consistent, but recommendations on use of hydrolysed formula and supplements varied considerably. CONCLUSION : The overall quality of a CPG for Food Allergy and Atopic Dermatitis prevention did not correlate well with its global applicability. It is imperative that CPG developers consider stakeholders’ preferences, local applicability, and adapt existing individual population and healthcare system to ensure successful implementation. There is a need for development of high-quality CPGs for allergy prevention outside of North America and Europeen© 2023 The Authors. Published by Elsevier Inc. on behalf of World Allergy Organization. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Allergy preventionFood allergyAtopic dermatitisEczemaClinical practiceGuidelineQualityApplicabilityConsistencyAGREE IIAGREE-REXSystematic reviewSDG-03: Good health and well-beingClinical practice guidelines (CPGs)Article