Research offers promising way to enhance food allergy diagnosis
Accurate diagnosis of food allergy is essential for proper management of the condition. Double-blind, placebo-controlled food challenges (DBPCFC) are the gold standard for diagnosing food allergy, but they are time-consuming and costly and, often, a source of risk that a severe systemic allergic reaction might occur during a food challenge. Thus, there is a need for a diagnostic tool that can accurately predict what the outcome of a food challenge would be. Although research has been conducted on developing such a tool, it has not yet been done from a comprehensive perspective, or with conclusive results.
In a study published in the March 2011 issue of The Journal of Allergy and Clinical Immunology (JACI), DunnGalvin et al proposed that combining clinical data with the results of commonly used allergy tests like skin prick test and serum IgE would improve the ability to predict the outcome of a food challenge. They reasoned that the more clinical information that could be considered, the more accurate a predictive model would be. Studying a group of children who were candidates for oral food challenge for peanut, milk or egg, the authors analyzed different combinations of data to create diagnostic algorithms. They looked at the outcomes of combinations of data on clinical factors (skin prick test, allergen specific IgE in serum, total IgE, allergic reaction history, sex, and age); they then compared those to the results of the children’s food challenges.
From this analysis, they appeared to have developed an effective prediction model, “a calculator”, of a positive food challenge that was a more accurate predictor than individual allergy tests. Using their model on a new group of children undergoing food challenges, 97% of cases were accurately predicted as positive, and 94% as negative. The authors’ findings have implications for a potentially more cost-effective method of determining food allergy, which will ultimately help provide better care to food-allergic patients.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.