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Allergy testing at OLCHC

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Background

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.

Methodology

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

  • Grass sIgE

  • Common food panel

  • Fruit sIgE

Results

  1. 1.

    HDM sIgE

    • 679 tests were ordered

    • 25% of all tests were ordered on those <2 yrs and only 15/153 (10%) were positive.

Table 1 Table 1
  1. 2.

    Grass pollen sIgE

    • 638 tests were ordered

    • 73% were negative

Positivity increased with age consistent with all international data.

Table 2 Table 2
figure1

Figure 1

  1. 3.

    Testing for fruit allergy

    • All of these tests were negative

Table 3 Table 3
  1. 4.

    The common food panel:

    • 519 tests were performed

    • 59% of these were entirely negative

figure2

Figure 2

Table 4 Table 4

Author information

Correspondence to Cathryn O'Carroll.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Keywords

  • Food Allergy
  • Health Care Worker
  • Medical Practitioner
  • Grass Pollen
  • Cost Efficiency