TDNet Discover

Background: Increasing sensitizations to food amongst rising generations has created a challenge for the health care system to determine the correct path of assessing the degree of allergic response in patients. Currently the gold diagnostic standard is the Oral Food Challenge (OFC), however the most commonly practiced is the Skin Prick Test (SPT). The SPT due to easy accessibility and low cost is often chosen as a first line test, however the atopic response cannot determine the level of reaction a patient would have if the allergen was ingested. On the other hand, OFC is a great undertaking, requiring a moderate amount of risk, time, and care, but guarantees understanding sensitization levels, and development of a better treatment plan. Objective/Purpose: Health care providers must find if there is a way to get similar understanding using the SPT by classifying various feedback such as wheal size, and other side effects, so that providers can safely assume after certain cut-off that a patient would have a positive reaction to an OFC. Study Design: This research employed a systematic literature review study design that searched for publications within the last 20 years. Methods: This study design and methods were adapted from a previous systematic literature review on the diagnosis and management of food allergies. In order to select the most appropriate articles we generally limited our search to include studies that was yet to be included within the afore mentioned paper. Results: The seven articles included reviews that were individually analyzed to extract as much data as possible. Through this process themes were identified between the articles that highlight the strengths and weaknesses of each one. Several articles presented results that showed the SPT alone is overly sensitive, not effective, or valid enough to diagnose allergies on its own. IS A SPT AS EFFECTIVE AT DIAGNOSING FOOD ALLEGIES AS AN OFC iv Inconsistencies in testing modalities, NIH quality scores, and testing procedure are included in table 1 of the results. Discussion: This research provides evidence that SPTs have strong variation among clinician in testing protocols and they lack in sensitivity to accurately diagnose food allergies. Therefore, oral food challenge should be clinically utilized as the diagnostic standard. Conclusion: This systematic literature review was limited by design to only include articles that pre-screened their participants for confirmed allergy diagnosis. Therefore, we would recommend any further reviews incorporate studies that include a wider variety of patient populations, not limited to the general public or individuals who do not have allergy symptoms