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使用吸入性和食物过敏原检测板的处方适宜性:意大利热那亚全科医生与过敏症专科医生处方的比较

Prescriptive appropriateness using inhalant and food allergen panels: a comparison between General Practitioners' and Allergists' prescription in Genoa (Italy).

作者信息

Ciprandi G, Comite P, Ferrero F, Montaruli R, Mussap M

机构信息

Internal Medicine Department, IRCCS-AOU San Martino - IST, Largo R. Benzi 10, 16132 Genoa, Italy. E-mail:

Laboratory Medicine, IRCCS-AOU San Martino - IST, Genoa, Italy.

出版信息

Eur Ann Allergy Clin Immunol. 2017 Mar;49(2):80-83.

Abstract

Prescriptive appropriateness is an actual claim in healthcare, and it also concerns in vitro tests used in the allergy work-up, such as the serum allergen-specific IgE (sIgE) assay. In the Liguria Region, two panels were defined (for inhaled and food allergens) including 12 allergens. Their composition changed over time. The aims of the present retrospective study were: i) to evaluate the percentage of positive tests, and ii) to compare the findings of sIgE assay on the basis of the general practictioners' (GPs) or specialist' prescription, considering both the old panels and the new panels. This retrospective study considered a population of adult patients, which consisted of 2368 subjects (68% females; mean age 50 years; age range: 10-103 years). Serum sIgE were measured by ImmunoCap system. The percentages of positive tests were very low for food allergens and low for inhaled ones (ranging between 5% to 35%). There was change of prevalent prescriptor with new panels. This study underlines the relevance of prescriptive appropriateness in the allergy work-up. The sIgE assay should be limited to those allergens that have a clinical relevance, based on clinical history.

摘要

规范性适宜性是医疗保健中的一项实际主张,它还涉及过敏诊断中使用的体外检测,如血清过敏原特异性IgE(sIgE)检测。在利古里亚地区,定义了两个检测组(针对吸入性和食物过敏原),包括12种过敏原。其组成随时间变化。本回顾性研究的目的是:i)评估检测呈阳性的百分比,ii)根据全科医生(GP)或专科医生的处方,比较新旧检测组sIgE检测的结果。这项回顾性研究纳入了成年患者群体,共2368名受试者(68%为女性;平均年龄50岁;年龄范围:10至103岁)。血清sIgE通过免疫捕获系统进行检测。食物过敏原检测呈阳性的百分比非常低,吸入性过敏原检测呈阳性的百分比则较低(在5%至35%之间)。新检测组的主要开方医生有所变化。本研究强调了规范性适宜性在过敏诊断中的相关性。基于临床病史,sIgE检测应限于那些具有临床相关性的过敏原。

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