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We read with interest the paper by Weston et al of a well designed and well carried out trial on the effects of probiotics in schoolchildren with atopic dermatitis.1 We have two methodological questions related to the authors’ conclusions.
First, in the discussion section the authors claim that this is the first study to show a benefit following administration of probiotics in children with moderate to severe atopic dermatitis. In our opinion this conclusion is not supported by the data generated by this study. Our main reason is that most changes in outcome found refer to changes within treatment groups and not differences between treatment groups. In a placebo controlled trial, changes within the intervention (probiotic) group may indicate a beneficial effect, but could also be due to a beneficial change in the course of the disease over time, regardless of the intervention. Therefore, a placebo group is included to control for the …