Randomized Trial of Peanut Consumption Study
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Randomized Trial of Peanut Consumption Study

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Questions and Answers

What was the primary outcome measured in the study?

  • Food allergy to one or more of six allergenic foods (correct)
  • The effectiveness of breast-feeding duration
  • The development of asthma symptoms
  • The frequency of skin infections in infants
  • What procedure was used to determine if a child had an allergy at baseline?

  • Skin prick testing with allergenic substances (correct)
  • Blood test for immunoglobulin levels
  • Oral food challenges prior to introduction
  • Dietary recall assessments
  • What action was taken if infants in the early-introduction group had a positive result on the food challenge?

  • They continued to consume 2 g of the allergenic protein weekly.
  • They were allowed to consume the food but monitored closely.
  • They were instructed to avoid all allergenic foods.
  • They were instructed to avoid that specific food but could continue with others. (correct)
  • Why did the standard-introduction group not undergo skin-prick testing at baseline?

    <p>It could have influenced when allergenic foods were introduced.</p> Signup and view all the answers

    What was the total amount of allergenic protein administered during the open-label food challenge?

    <p>2 g of protein</p> Signup and view all the answers

    What was the recommended practice for the control group regarding infant feeding?

    <p>Exclusive breast-feeding until at least 6 months of age</p> Signup and view all the answers

    What happens to the skin reaction from skin prick testing if a child is allergic?

    <p>A small bump develops and then disappears after about 30 minutes.</p> Signup and view all the answers

    What is the purpose of conducting blood tests in the study?

    <p>To understand why some children develop food allergies.</p> Signup and view all the answers

    What was the intention-to-treat analysis (ITT) outcome for food allergy prevalence in the early-introduction group?

    <p>5.6%</p> Signup and view all the answers

    What method was used for statistical comparison of food allergy prevalence between the two groups?

    <p>Chi-square test / Fisher exact test</p> Signup and view all the answers

    What was the power of the study at the 5% significance level?

    <p>80%</p> Signup and view all the answers

    How many participants were included in the intention-to-treat analysis for the early-introduction group?

    <p>652</p> Signup and view all the answers

    In which group was the prevalence of food allergy significantly lower when analyzed per-protocol?

    <p>Early-introduction group</p> Signup and view all the answers

    What was the food allergy prevalence in the standard-introduction group according to the ITT analysis?

    <p>7.1%</p> Signup and view all the answers

    What additional method did parents in the early-introduction group use to track food consumption?

    <p>Weekly diary</p> Signup and view all the answers

    Which of the following groups had a higher percentage of food allergy prevalence in the per-protocol analysis?

    <p>Standard-introduction group</p> Signup and view all the answers

    What is the main purpose of randomization in clinical trials?

    <p>To minimize selection bias by creating similar groups</p> Signup and view all the answers

    Which type of blinding means that all parties are aware of the treatment allocation?

    <p>Unblinded / open label</p> Signup and view all the answers

    What defines intention to treat (ITT) analysis in clinical trials?

    <p>It includes every subject according to their randomized treatment assignment.</p> Signup and view all the answers

    Why is blinding important in clinical trials?

    <p>It helps reduce or eliminate bias in assessment of outcomes.</p> Signup and view all the answers

    Which of the following statements about double blind studies is true?

    <p>Both participants and clinicians/data collectors are unaware of treatment assignments.</p> Signup and view all the answers

    What occurs during the process of un-blinding in a clinical trial?

    <p>Participants are informed after the trial about the treatment they received.</p> Signup and view all the answers

    What is a potential consequence of applying intention to treat (ITT) analysis?

    <p>It ignores protocol deviations and noncompliance.</p> Signup and view all the answers

    In research, what is the primary role of statisticians when collaborating with clinicians?

    <p>To explore hypotheses and validate assumptions using data.</p> Signup and view all the answers

    What is a better application of the ITT approach according to clinical research?

    <p>If complete outcome data are available for all randomized subjects</p> Signup and view all the answers

    What was the primary finding of the LEAP study regarding peanut consumption in infants?

    <p>It decreased the frequency of peanut allergy in high-risk children</p> Signup and view all the answers

    What characterizes a per protocol analysis in clinical trials?

    <p>It focuses on participants who completed the study without major protocol violations</p> Signup and view all the answers

    What was the role of Professor Gideon Lack in the LEAP study?

    <p>He led the study at Kings College London</p> Signup and view all the answers

    What future research direction was suggested following the LEAP study?

    <p>To explore the introduction of more types of allergenic foods</p> Signup and view all the answers

    How many exclusively breast-fed infants were recruited for the EAT Study?

    <p>1303</p> Signup and view all the answers

    What was the age of the infants at the time of recruitment for the EAT Study?

    <p>3 months</p> Signup and view all the answers

    Which of the following is a notable aspect of the conclusions drawn from the LEAP study?

    <p>It indicated that early peanut introduction modulated immune responses</p> Signup and view all the answers

    Study Notes

    Role of Statisticians in Clinical Research

    • Statisticians collaborate with clinicians to test hypotheses and validate assumptions through data analysis.

    Randomized Trial of Peanut Consumption

    • Focuses on infants at risk for peanut allergies.
    • Employs randomization, blinding, and both intention-to-treat (ITT) and per-protocol analyses.

    Randomization

    • Ensures random allocation between experimental and control groups to eliminate selection bias.
    • Achieves baseline similarity among groups.

    Blinding in Clinical Trials

    • Blinding masks treatment information to participants to reduce bias.
    • Types of blinding:
      • Unblinded/Open label: All parties know treatment allocations.
      • Single blind: Participants are unaware of their treatment.
      • Double blind: Both participants and clinicians/data collectors are unaware.
      • Triple blind: Participants, clinicians/data collectors, and analysts are all unaware.

    Intention-to-Treat (ITT) Analysis

    • Includes all randomized subjects, maintaining prognostic balance and accounting for noncompliance and protocol deviations.
    • Generally yields conservative estimates of treatment effects.

    Per Protocol Analysis

    • Analyzes a subset of participants who adhered strictly to the study protocol.

    LEAP Study

    • “Learning Early About Peanuts” trial published in NEJM.
    • Demonstrated that early peanut consumption in high-risk infants reduces the development of peanut allergies.
    • First significant trial targeting food allergy prevention in infants.

    Study Conclusions

    • Early peanut introduction significantly decreased peanut allergy rates and altered immune responses.

    Further Research Directions

    • Investigate the introduction of additional allergenic foods to infants.

    EAT Study Overview

    • Randomized trial examining the early introduction of multiple allergenic foods in breastfed infants.
    • Included 1303 exclusively breast-fed infants, randomly assigned to early introduction of six allergenic foods or standard practice of exclusive breastfeeding until ~6 months.

    Key Allergens Tested

    • Foods included peanut, cooked egg, cow's milk, sesame, whitefish, and wheat.

    Skin Prick Testing

    • Measures allergen sensitivity through skin reaction.
    • Requires monitoring for wheal response within minutes.

    Blood Testing

    • Aids in understanding food allergy development through samples collected at specific intervals.

    Participant Follow-Up

    • Included a monthly online questionnaire on allergenic food consumption for the first year, and every three months until age three.
    • Early-introduction group maintained a weekly diary of allergenic food intake.

    Statistical Methods and Study Power

    • Employed ITT analysis for comprehensive assessment of primary outcomes using chi-square tests and Fisher exact tests.
    • Study designed to detect a reduction in food allergy prevalence from 8% to 4% with 80% power at a 5% significance level.

    Results

    • ITT analysis: Food allergy prevalence was 7.1% (standard) vs. 5.6% (early-introduction); not statistically significant (P = 0.32).
    • Per-protocol analysis revealed significantly lower allergy rates in the early-introduction group (2.4% vs. 7.3%, P = 0.01).

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    Description

    Explore the outcomes of the 'Learning Early About Peanut' (LEAP) trial, which investigated peanut consumption in infants at risk for peanut allergy. The quiz examines the intent-to-treat (ITT) approach and per protocol analysis as it relates to the study's findings. Test your knowledge of essential concepts and methodologies in clinical trial research.

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