| Chalmers 2020 |
Low risk of bias |
Quote: "The randomisation schedule was created by the CTU using computer‐generated pseudo‐random code with permuted blocks of randomly varying size. The sequence was known only to the programmer until database lock." Baseline variables by treatment group do not suggest a problem with randomisation, characteristics well balanced (IPD available) |
Low risk of bias |
Not possible to blind participants’ carers, but there is no evidence that deviations arised because of the trial context. The control group rates of skin care application were consistent with other trials and observational studies (e.g. up to 75 % in Rendell et al. 2011). Quote: “Of families in the emollient group with complete questionnaire data on adherence at each time point, 466 (88%) of 532 had satisfactory adherence at 3 months, 427 (82%) of 519 at 6 months, and 375 (74%) of 506 at 12 months.” “No emollient was supplied to the control group, but self‐directed use of emollients at least three times per week to most of the body (contamination) occurred in 18% (82 of 457) at 3 months, 17% (62 of 372) at 6 months, and 15% (49 of 324) at 12 months.” |
Low risk of bias |
Outcome available for 988/1394=71%. Sensitivity analysis using the IPD data shows conclusions do not change if all missing are assumed to not have any allergic sensitisation, RR=1.21, 95% CI 0.90 to 1.61, or if everyone missing is assumed to have any allergic sensitisation, RR=1.06, 95% CI 0.94 to 1.21. |
Low risk of bias |
Quote: "Research nurses doing skin examinations, skin prick testing, food challenges, or making food allergy decisions, and the statistician, were masked to treatment allocation during the study." |
Low risk of bias |
Full trial dataset provided by investigators and IPD meta‐analysis SAP followed. |
Low risk of bias |
Low risk of bias in all domains. |
| Lowe 2018a |
Low risk of bias |
Quote from trial protocol: "A computer generated random allocation list in blocks of variable length (4‐12) will be used. This list will be held by The RCH Pharmacy Department, which will be independent from the participant recruitment or testing. At all times, the allocation list will be concealed from the study coordinator and the other study investigators, who will manage participant recruitment." Baseline variables by treatment group do not suggest a problem with randomisation, characteristics well balanced (IPD available). |
Low risk of bias |
Not possible to blind participants’ carers, but there is no evidence that deviations arised because of the trial context. The control group rates of skin care application were consistent with other trials and observational studies e.g. up to 75 % in Rendell et al. 2011. The IPD shows regular use of emollient (≥ 3 days a week) by 11/36 (31%) control participants and 30/38 (79%) with eczema outcome recorded). |
Some concerns |
Outcome available for 70/80=88% of randomised participants at 12 months. Sensitivity analysis using the IPD reveals conclusions do not change significantly if everyone missing is assumed to not have allergic sensitisation, 0.68 [0.27 to 1.71] but conclusions change if all missing the outcome are assumed to have allergic sensitisation, 1.04 [0.53 to 2.01] (point estimate of RR >20% of the complete case estimate). Missingness could have depended on outcome, but not likely. |
Low risk of bias |
Skin prick tests used by blinded assessor. |
Low risk of bias |
Full trial dataset provided by investigators and IPD meta‐analysis SAP followed. |
Some concerns |
Some concerns due to missing data (12% and result varied in sensitivity analysis) but low risk of bias in all other domains. |
