Canadian Society of Allergy and Clinical Immunology position statement: panel testing for food allergies

Abdulrahman Al Ghamdi; Elissa M Abrams; Stuart Carr; Mariam A Hanna; Sari M Herman; Elana Lavine; Harold Kim; Timothy K Vander Leek; Douglas P Mack

doi:10.1186/s13223-024-00937-0

Canadian Society of Allergy and Clinical Immunology position statement: panel testing for food allergies

Allergy Asthma Clin Immunol. 2024 Nov 29;20(1):61. doi: 10.1186/s13223-024-00937-0.

Authors

Abdulrahman Al Ghamdi^{1

2}, Elissa M Abrams^{3

4}, Stuart Carr⁵, Mariam A Hanna⁶, Sari M Herman⁷, Elana Lavine⁸, Harold Kim^{9

10}, Timothy K Vander Leek^{11

12}, Douglas P Mack^{13

14}

Affiliations

¹ Division of Allergy and Immunology, Department of Pediatrics, University of Toronto, Toronto, Canada.
² Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
³ Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Canada.
⁴ Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, Canada.
⁵ Snö Asthma & Allergy, Abu Dhabi, United Arab Emirates.
⁶ McMaster University, Hamilton, ON, Canada.
⁷ Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
⁸ Department of Pediatrics, University of Toronto & Humber River Hospital, Toronto, ON, Canada.
⁹ Western University, London, ON, Canada.
¹⁰ Canada and McMaster University, Hamilton, ON, Canada.
¹¹ Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
¹² Department of Pediatrics, University of British Columbia, Vancouver, Canada.
¹³ Department of Pediatrics, McMaster University, Hamilton, ON, Canada. [email protected].
¹⁴ Halton Pediatric Allergy, 5500 North Service Road, Suite 106, Burlington, ON, L7L 6W6, Canada. [email protected].

Abstract

This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as "panel food testing." Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.

Keywords: Diagnosis; Food allergy; Harm reduction; Oral food challenge; Prevention of allergy; Screening test; Test limitations.

Publication types

Review