Food allergen panel testing often results in misdiagnosis of food allergy

J Pediatr. 2015 Jan;166(1):97-100. doi: 10.1016/j.jpeds.2014.07.062. Epub 2014 Sep 10.

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.

MeSH terms

  • Adolescent
  • Allergens*
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Diagnostic Errors
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / economics
  • Humans
  • Infant
  • Predictive Value of Tests
  • Retrospective Studies
  • Skin Tests / economics
  • Skin Tests / methods*

Substances

  • Allergens