Food Allergen Panel Testing Often Results in Misdiagnosis of Food Allergy

• Published in: The Journal of pediatrics 2015-01, Vol.166 (1), p.97-100.e1
• Main Authors: Bird, J. Andrew, MD, Crain, Maria, CPNP, Varshney, Pooja, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Allergens; Child; Child, Preschool; Costs and Cost Analysis; Diagnostic Errors; Food Hypersensitivity - diagnosis; Food Hypersensitivity - economics; Humans; Infant; Pediatrics; Predictive Value of Tests; Retrospective Studies; Skin Tests - economics; Skin Tests - methods
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2014.07.062

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.