Testing for allergic disease: Parameters considered and test value
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Date
2008-08-26
Journal Title
Journal ISSN
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Publisher
BioMed Central
Abstract
Background: Test results for allergic disease are especially valuable to allergists and family
physicians for clinical evaluation, decisions to treat, and to determine needs for referral.
Methods: This study used a repeated measures design (conjoint analysis) to examine trade offs
among clinical parameters that influence the decision of family physicians to use specific IgE blood
testing as a diagnostic aid for patients suspected of having allergic rhinitis. Data were extracted from
a random sample of 50 family physicians in the Southeastern United States. Physicians evaluated 11
patient profiles containing four clinical parameters: symptom severity (low, medium, high),
symptom length (5, 10, 20 years), family history (both parents, mother, neither), and medication
use (prescribed antihistamines, nasal spray, over-the-counter medications). Decision to
recommend specific IgE testing was elicited as a "yes" or "no" response. Perceived value of specific
IgE blood testing was evaluated according to usefulness as a diagnostic tool compared to skin
testing, and not testing.
Results: The highest odds ratios (OR) associated with decisions to test for allergic rhinitis were
obtained for symptom severity (OR, 12.11; 95%CI, 7.1–20.7) and length of symptoms (OR, 1.46;
95%CI, 0.96–2.2) with family history having significant influence in the decision. A moderately
positive association between testing issues and testing value was revealed (β = 0.624, t = 5.296, p
≤ 0.001) with 39% of the variance explained by the regression model.
Conclusion: The most important parameters considered when testing for allergic rhinitis relate
to symptom severity, length of symptoms, and family history. Family physicians recognize that
specific IgE blood testing is valuable to their practice.
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Citation
Sheryl L. Szeinbach et al, "Testing for allergic disease: Parameters considered and test value," BMC Family Practice 9 (2009), doi: 10.1186/1471-2296-9-47, http://www.biomedcentral.com/1471-2296/9/47