Allergy testing at OLCHC
© O'Carroll et al; licensee BioMed Central Ltd. 2015
Published: 30 March 2015
Allergy is a growing problem in the western world. However, education of health care workers in the field of allergy has not kept up with clinical need. There has been much evidence that medical practitioners use diagnostic tests inaccurately, declaring food allergy where there is none. Removal of food from a patient's diet, especially a child's, has significant nutritional implications that can be irreversible and have a lifelong effect. Furthermore the cost of inappropriate tests is escalating. Guidelines have recently been set indicating that allergy focused history must guide all allergy orders: http://www.ifan.ie.
Aims of this audit
1. To optimise the allergy testing service provided for both clinicians and patients.
2. To examine whether allergy testing was in line with current guidelines.
3. To look for areas where cost efficiency could be improved.
4. To gather local data that can be incorporated into education sessions for clinicians.
All sIgE tests ordered through the laboratory at Our Lady's Children's Hospital, Crumlin, from May 8th to Nov 7th 2013, were made available in the form of an excel spread sheet. The outcomes of 4 tests were evaluated, according to age of patient and department from where order originated.
House Dust Mite sIgE
Common food panel
- 1.HDM sIgE
679 tests were ordered
25% of all tests were ordered on those <2 yrs and only 15/153 (10%) were positive.
- 2.Grass pollen sIgE
638 tests were ordered
73% were negative
3.8 + /-3.8
- 3.Testing for fruit allergy
All of these tests were negative
- 4.The common food panel:
519 tests were performed
59% of these were entirely negative
Clinicians have a poor understanding of how to use sIgE testing
Formal lecture to NCHDs
January 2014 (achieved)
Dr Aideen Byrne
Tests are being run inappropriately with considerable cost implications
Establish hospital protocol for ordering of IgE tests
Dr Cathryn O Carroll
Dr Aideen Byrne
Laboratory staff are unclear how to judge appropriateness of test order.
Establish clear guidelines for laboratory staff
Specific IgE testing for aeroallergens being ordered in wrong population
Orders for sIgE to HDM and Grass pollen not to be accepted under 2 years
Aideen Byrne Joe McNamara
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