Laboratory Strategies to Improve Allergy First-Line Screening in Primary Care

Lab Med. 2023 Sep 5;54(5):473-478. doi: 10.1093/labmed/lmac147.

Abstract

Background: There are nonestablished protocols in use for first-line allergy screening based on IgE testing. These protocols attempt to address an unmet need for sustainability of clinical laboratories, at a time when demand is increasing.

Objective: To present a novel protocol for first-line allergy screening and to evaluate the implementation benefits for patients, the health care system, and payers.

Methods: We carried out an observational retrospective study analyzing 4359 interventions on primary care testing requests. Interventions included overriding redundant serum IgE (sIgE) testing for allergen mixes, extracts included in mixes, low-prevalence extracts, and milk and egg molecular components without previous positive results when exposed to extracts. We also added prevalent allergen testing.

Results: The strategy saved 683 tests from being performed unnecessarily. Test volume decline was primarily driven by the cancelation of 2186 egg and milk components tests; 561 tests were added for mixes, together with 942 allergen extracts tests.

Discussion: The results of this study show how the allergy laboratory plays a key role in actively managing demand for sIgE testing, leading to optimized diagnosis.

Keywords: allergy testing; cost reduction; laboratory interventions; patient outcome improvement; primary care; screening.

MeSH terms

  • Allergens
  • Humans
  • Hypersensitivity* / diagnosis
  • Immunoglobulin E
  • Primary Health Care
  • Retrospective Studies

Substances

  • Allergens
  • Immunoglobulin E