Food Allergen Panel Testing Often Results in Misdiagnosis of Food Allergy - 10/09/14

Doi : 10.1016/j.jpeds.2014.07.062

J. Andrew Bird, MD ^1,^⁎ , Maria Crain, CPNP ², Pooja Varshney, MD ³
¹ Division of Allergy and Immunology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
² Division of Allergy and Immunology, Children's Medical Center, Dallas, TX
³ Department of Pediatrics, Division of Allergy and Immunology, Dell Children's Medical Center of Central Texas, Dallas, TX

^∗Reprint requests: J. Andrew Bird, MD, Division of Allergy and Immunology, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9063.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 10 September 2014

Abstract

Objective

To determine the utility of food allergy panel testing among patients referred to a pediatric food allergy center.

Study design

Retrospective chart review of all new patients seen between September 2011 and December 2012 by 1 provider in a tertiary referral pediatric food allergy center. A cost analysis was performed to calculate the estimated cost of evaluation for patients who have received a food allergy panel.

Results

Of 797 new patient encounters, 284 (35%) patients had received a food allergy panel. Only 90 (32.8%) individuals had a history warranting evaluation for food allergy; 126 individuals were avoiding a food based on recommendations from the referring provider and 112 (88.9%) were able to re-introduce at least 1 food into their diet. The positive predictive value of food allergy panel testing in this unselected population was 2.2%. The estimated cost of evaluation for this population was $79 412.

Conclusions

Food allergy panel testing often results in misdiagnosis of food allergy, overly restrictive dietary avoidance, and an unnecessary economic burden on the health system.

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Keyword : AD, NIAID, PPV