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食物过敏原面板检测常常导致食物过敏的误诊。

Food allergen panel testing often results in misdiagnosis of food allergy.

机构信息

Division of Allergy and Immunology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.

Division of Allergy and Immunology, Children's Medical Center, Dallas, TX.

出版信息

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.

摘要

目的

确定食物过敏面板检测在被转诊至儿科食物过敏中心的患者中的应用价值。

研究设计

对 2011 年 9 月至 2012 年 12 月期间,由一位医生在一家三级转诊儿科食物过敏中心诊治的所有新患者的病历进行回顾性分析。进行了成本分析,以计算接受食物过敏面板检测的患者的评估费用。

结果

在 797 例新患者中,有 284 例(35%)患者接受了食物过敏面板检测。只有 90 例(32.8%)患者有明确的食物过敏评估病史;126 例患者根据推荐的治疗方案避免食用某种食物,而 112 例(88.9%)患者至少能重新食用 1 种食物。在这个未经选择的人群中,食物过敏面板检测的阳性预测值为 2.2%。该人群的评估费用估计为 79412 美元。

结论

食物过敏面板检测常常导致食物过敏的误诊、过度限制饮食回避,以及对医疗系统造成不必要的经济负担。

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