There rarely passes a week when you don't hear or see something related to allergies, and the larger trend recently seems to revolve a great deal around food allergies. Despite what seems to be a sharp increase in the number of children allergic to specific foods, a recent article in the journal Pediactrics calls in to the question the use of modern allergy tests and how their overuse can be having a needlessly negative effect on children.

Lead authors, Scott Sicherer, MD and Robert Wood, MD suggest that with the current array of allergy tests commonly being used, relying strictly on the results of these in making a diagnosis leaves a lot of room for error. And with slight to dramatic lifestyle changes hinging upon the diagnosis of a potentially life threatening allergen, a more well rounded approach is advised.

Specifically, the researchers focued on the Skin Prick Test (SPT) and specific IgE (sIgE) blood test. A few interesting findings,

"Positive sIgE test results indicate sensitization, but are not equivalent to clinical allergy....

sIgE test results typically do not reflect the severity of allergies...

Allergy tests for sIgE must be selected and interpreted in the context of a clinical presentation; test relevance may vary according to the patient’s age, allergen exposure, and performance characteristics of the test."

Testing large panels of allergens without factoring in affecting circumstances like patient history, disease characteristics and geography can have severe consequences. Particularly with food allergies, you can often see measures of dietary change and extreme avoidance, which if not necessary, can be a hardship children can certainly do without.

Ultimately, they suggest that an overreliance on tests which can produce false negatives AND false positives in a given context can have major consequences for children. While there is no suggestion of disregarding tests, the study instead pushes the need for a more nuanced and balanced approach. A course of action that focuses on patient history, specific symptoms (less so an allergy to a specific allergen), and more frequent testing and observation can yield far more accurate results and treatment. A full version of the study can be found at Pediatrics.