Legislation about school management plans
It is unclear whether legislation requiring schools to have anaphylaxis management plans affects outcomes because the certainty of evidence is very low (supplement S8d). A case control study found that legislation improved the consistency of school policies with best practice guidelines (very low certainty) and was associated with a 13% increase in the proportion of school staff scoring 4 out of 4 on observed autoinjector technique (statistically significant, CI not reported, very low certainty).11Cicutto L, Julien B, Li NY, Nguyen-Luu NU, Butler J, Clarke A, Elliott SJ, Harada L, McGhan S, Stark D, Vander Leek TK, Waserman S. Comparing school environments with and without legislation for the prevention and management of anaphylaxis. Allergy 2012;67(1):131-137.