Thursday, March 01, 2007

More Allergy and Intolerance Testing Nonsense: Part 1

Images of pirates engaged in various activities
Recently, I commented on Hardman and Hart's recently published audit of YorkTest's IgG-guided food elimination diets and chronic medical conditions. Although the survey was sponsored by Allergy UK it is a poor study that does not provide enough detail to be able to evaluate either its conclusions or its publicity. I had hoped that the study was so self-evidently incapable of supporting swashbuckling or grandiose claims that people who profess an interest in decent science or a reputable evidence base would not over-state its significance.

YorkTest has published a summary of some of the paper's findings that make substantial claims about its significance and criticises the NHS: 10 Years of NHS treatment and still we're ill says study. I must reiterate at this point that the survey does not include any verification of the participants' claims about when they first reported the symptoms to a GP or representative of the NHS. There is no summary of medical treatments that the participants followed and whether any of them were being followed at the time of the YorkTest 113 foodSCAN guided elimination diet.

Allergy UK and YorkTest have been talking up this audit for some time. I've seen references to more than 7000 participants, 5000 participants, and for the relevant claim about unsuccessful treatment by the NHS, this is now modified further:
T[t]he findings, conducted by York University, suggest a growing dissatisfaction among patients who wasted time and money on treatment on the NHS. The study using 3219 patients and published in the February issue of Nutrition and Food Science looked at a range of mild and chronic illnesses including migraine / headache, skin symptoms, IBS, and digestive problems.
Elsewhere on their site, YorkTest summarises the YorkTest 5200 Patient Survey (aka Testing Times report [pdf] which is an advance version of the journal paper).
Three months after taking a 113 foodSCAN test, we send a satisfaction questionnaire out to our customers to find out how they are getting on, what benefits they have experienced and how they felt about the test and service. This independently audited report has been produced to provide evidence that an elimination diet based on food-specific IgG results is an effective, reliable and valid aid to the management of chronic conditions. This will be published in February 2007 in the International Journal of Nutrition and Food Science.
This was a perfect opportunity to disseminate all of the data that it wouldn't have been practical to include in the journal paper. Why have neither Allergy UK nor YorkTest made the full detail of this study available? According to the journal paper, the data are drawn from a questionnaire with scaled category responses, yet, according to the current claims, it now seems as if the participants were invited to complain, or spontaneously complained about their NHS treatment. However, from YorkTest's own summary it now seems as if they are referring to a "satisfaction questionnaire". Is this why there was a different version of the questionnaire? If it was YorkTest's own customer satisfaction questionnaire than why did Allergy UK pay for the audit? I'm sure that there are some straightforward explanations but all of these different descriptions make it very confusing.

Does YorkTest usually ask its customers for information about their NHS experiences? Was this question only added in for the Allergy UK-sponsored audit? What were these questions about the NHS? How were they phrased?

The paper's claims can not be substantiated or evaluated without this information. It is time to publish the questionnaires and the full data from this audit. Without the full information it is impossible to evaluate the claims that are being made and that is an unsatisfactory situation that may well lead to many mis-understandings and might mislead some desperate people. I am particularly annoyed that it seems as if somebody associated with YorkTest may be attempting to use these findings as the basis of an e-petition to have food intolerance tests made available on the NHS.

For years we have been told, "The evidence is coming. Trials are in progress" and this is what we get?

Images courtesy of Flickr. 1. Pirate, 2. Pirates, 3. Pirate Contemplation, 4. Yarr there be Pirates!

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