Australasian Society of Clinical Immunology and Allergy
ASCIA is the professional body for allergy & clinical immunology in Australia & New Zealand. ASCIA is a member of the World Allergy Organisation (WAO) & is affiliated with the Royal Australasian College of Physicians (RACP).
4.
Food specific IgE testing should not be performed without a clinical history suggestive of IgE-mediated food allergy.
Reliable and proven diagnostic tests for food allergy include skin prick testing, blood tests for food specific IgE antibodies and medically supervised food allergen challenges. Allergy test results should never be used on their own, and must be considered together with the patient's clinical history. In the absence of a history of clinical symptoms, low levels of allergen-specific IgE are usually of little diagnostic significance.
Allergy testing of individuals where there is no evidence that food allergy plays a role in their clinical symptoms increases the likelihood of irrelevant false positive results. This may lead to potential harm due to inappropriate and unnecessary dietary restrictions, with nutritional implications for the individual (particularly in children) and unnecessary fear and anxiety (particularly for the family or carers).
For further information go to www.allergy.org.au/patients/food-allergy
Supporting evidence
- Sicherer and Wood, ‘Allergy Testing in Childhood: Using Allergen-Specific IgE Tests’, Pediatrics. 2012 Jan;129(1):193-7. doi: 10.1542/peds.2011-2382. Epub 2011 Dec 26.
- Bernstein et al, ‘Allergy Diagnostic Testing: An Updated Practice Parameter’, Ann Allergy Asthma Immunol. 2008 Mar;100(3 Suppl 3):S1–148.
How this list was made
The RACP Strategic Policy and Advocacy group assisted ASCIA in compiling the original list of 25 tests, treatments and services, that have been identified either in past work by ASCIA, other literature reviews or in evidence reviews performed by overseas specialist physician bodies or health agencies as being overused, inappropriate or of limited effectiveness.
Two electronic surveys were sent to ASCIA members who are Fellows of the RACP (256 members in total) in February 2015 and March 2015, to firstly rank a top 5 from the list of 25, and secondly to review the wording and rankings of the top 5 recommendations. The overall response rate for these surveys was 20%. All ASCIA members and relevant patient organisations were then invited to review the list.
Related recommendations
- 1 Don’t use antihistamines to treat anaphylaxis – prompt administration of adrenaline (epinephrine) is the only treatment for anaphylaxis.
- 2 Alternative/unorthodox methods should not be used for allergy testing or treatment.
- 3 Allergen immunotherapy should not yet be used for routine treatment of food allergy – research in this area is ongoing.
- 4 Food specific IgE testing should not be performed without a clinical history suggestive of IgE-mediated food allergy.
- 5 Don’t delay introduction of solid foods to infants - ASCIA Guidelines for Infant Feeding and allergy prevention recommend introduction of solid foods to infants, around 6 months of age.