Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
J Allergy Clin Immunol. 2013 Jan;131(1):150-6. doi: 10.1016/j.jaci.2012.07.016. Epub 2012 Sep 1.
Childhood food allergy is a serious health problem. However, little is known about the frequency and manner in which it is currently diagnosed.
To describe parent report of physician practices in the diagnosis of pediatric food allergy.
Data from children with food allergy were identified for analysis from a representative survey administered in US households with children from June 2009 to February 2010. Analyses were performed at the level of the allergy. Demographic characteristics, symptom prevalence, and diagnostic methods were calculated as weighted proportions. Adjusted models were estimated to examine the association of reaction history and allergenic food with odds of physician diagnosis and testing.
Food allergies (n = 3,218) to 9 common allergens were reported among 2,355 children in a sample of 38,480. We found that 70.4% of reported food allergy was diagnosed by a physician. Among physician-diagnosed food allergy, 32.6% was not evaluated with diagnostic testing, 47.3% was assessed with a skin prick test, 39.9% with a serum specific IgE test, and 20.2% with an oral food challenge. Odds of physician diagnosis and testing were significantly higher for severe versus mild/moderate food allergy. Urticaria and angioedema were not reported as symptoms in 40.7% and 34.6% of severe food allergies, respectively.
Thirty percent of parent-reported food allergies in this study were not diagnosed by a physician. One in 5 physician-diagnosed allergies was evaluated with oral food challenge. Understanding parent report of practices in food allergy provides insight into ways in which to streamline the diagnosis and management of care.
儿童食物过敏是一个严重的健康问题。然而，目前对于其诊断的频率和方式知之甚少。
描述父母报告的儿科食物过敏的医生诊断实践。
从 2009 年 6 月至 2010 年 2 月在美国有儿童的家庭中进行的代表性调查中确定了食物过敏儿童的数据进行分析。在过敏水平上计算了人口统计学特征、症状流行率和诊断方法的加权比例。采用调整模型来检验过敏反应史和致敏食物与医生诊断和检测的可能性的关联。
在 38480 名样本儿童中，有 2355 名儿童报告了 9 种常见过敏原的食物过敏（n=3218）。我们发现，报告的食物过敏中有 70.4%是由医生诊断的。在医生诊断的食物过敏中，32.6%未经诊断性检测评估，47.3%采用皮肤点刺试验，39.9%采用血清特异性 IgE 检测，20.2%采用口服食物激发试验。严重食物过敏与轻度/中度食物过敏相比，医生诊断和检测的可能性显著更高。分别有 40.7%和 34.6%的严重食物过敏未报告荨麻疹和血管性水肿。
在这项研究中，30%的父母报告的食物过敏未被医生诊断。在医生诊断的过敏中，1/5 接受了口服食物激发试验。了解父母对食物过敏实践的报告为简化诊断和管理护理提供了深入了解。
