Does Provider Specialty Matter? Variation in Serum Allergen-Specific IgE Testing Patterns in Pediatric Patients

• Published in: American journal of clinical pathology Vol. 152; no. 6; pp. 701 - 705
• Main Authors: Stubblefield, Jeannie M, Lasley, Mary V, Virant, Frank S, Dickerson, Jane A
• Format: Journal Article
• Language: English
• Published: Chicago Oxford University Press 01.12.2019
• Subjects: Allergens; Immunoglobulin E; Laboratories; Pediatrics; United States
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/AJCP/AQZ097

Objectives: Multiple practice guidelines discourage indiscriminate use of broad panels of allergen-specific IgE (sIgE) tests due to increased risk of false positives and misinterpretation of results. We provide an analytical framework to identify specialty-specific differences in ordering patterns and effectiveness, which can be used to improve test utilization. Methods: Test results from a tertiary pediatric hospital were analyzed by ordering specialty to evaluate size of allergen workups. Positivity rates were analyzed to determine effectiveness in selecting tests with high positive pretest probabilities. Laboratory test menu components were also evaluated. Results: Our findings demonstrate 29% of sIgE tests are ordered as part of broad workups (>20 sIgE tests/date of service) contrary to the recommended testing approach. Detailed descriptions of ordering patterns and positivity rates are provided. Conclusions: This study provides a framework for using a cross-sectional analytical approach to assess test utilization patterns and evaluate components of laboratory testing menus. Key Words: Allergen; IgE testing; Allergy testing; Pediatric; Test utilization; Immunology; Immunoassay