Berghuizen, M.A. (Marlouk) (2013) Vooringenomenheid van kinderartsen bij de beoordeling van dubbelblinde placebogecontroleerde voedselprovocaties:Een gerandomiseerde trial. thesis, Medicine.
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Abstract
Aim: Examine whether the moment of opening the ‘key’ matters to the results of the double-blind placebo-controlled food challenges (DBPGFC). Design: Randomized controlled trial. Method: 51 experimental subjects with experience in interpreting DBPGFC's, were divided in two study groups. All subjects received the same 19, already performed, DBPGFC’s to evaluate. These DBPGFC’s were difficult to critize. Group A (N=26) interpreted the first and second testing day before they looked at the corresponding ‘key’. After viewing the ‘key’ they gave their final conclusion. Group B first looked at the ‘key’, then they interpreted the first and second testing day and finally they gave their final conclusion of the DBPGFC. The subjects could interpreted the DBPGFC as positive (symptoms related to allergy), negative (symptoms not related to allergy) or non-conclusive (symptoms dubious). The sign-test was used to investigate if there where differences in the numbers of tests (and testing days) which were issued as positive between group A and B. Results: From the reviews of the final conclusions group A interpreted 14 tests more frequently positive than group B, compared to 4 tests which were more frequently positive interpreted by group B. Only one test was concluded as allergic by all subjects (p=0.031). At the first testing day group A interpreted 10 tests more frequently positive, compared with 5 tests in group B. The remaining 4 tests were interpreted an equal number of times positive or negative by both groups (p=0.302). At the second testing day group A rated significantly more tests positive (12 tests) than group B (1 test). The other 6 tests were interpreted by both groups as frequent positive or negative (p=0.003). The differences in interpretation of the overall test result, are not explained by differences between the groups regarding the children’s medical attention ´allergy´ or other/general, p=0.481 (in the total group of subjects) and p=0.238 (in the group of pediatricians), and the profession (pediatrician or nurse specialist, p=0.815). The difference in evaluation between group A and B was mainly seen in children between 3 and 13 years (p=0.004) and not in 'younger' children (p=1.000). Subjects noted that they would not start 31,5% of the tests (6 tests) because of the non-optimal basic situation prior to the test days (for example the child was sick, was using medications for an intercurrent illness, or was vaccinated the day before the challenge). Conclusion: Opening the ‘key’ in advance influences the interpretation of difficult to interpret double-blind placebo-controlled food challenges, namely, this leads to a less positive evaluation of the challenges by the evaluators. This is particularly true in ‘older’ children with vague and non-specific symptoms, and if the child was sick at the start of the challenge.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Brand, Prof. dr. P.L.P. and kinderarts. and Locatie: Amalia kinderafdeling, Isala Klinieken Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1695 |
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