Clinicians continue to order broad serum immunoglobulin E food allergy panels despite widespread clinical recognition that the tests frequently return false-positive results, according to survey data presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting in Phoenix, Arizona.
- High False-Positive Rates: Broad blood tests for food allergies frequently show sensitivity where no actual clinical allergy exists.
- Guideline Discordance: Medical guidelines advise against using these broad panels for unsupported indications, yet many practitioners still order them.
- Patient Harm: Unnecessary testing leads families to eliminate safe foods from their diets, creating avoidable stress and financial costs.
Investigators distributed voluntary, anonymous surveys via email and Epic messages to 300 clinicians who ordered at least one food allergy panel in 2024 at an institution where more than 1,700 such panels were ordered that year. Forty-three clinicians responded, representing a response rate of approximately 14%. The institutional review board exempted the survey from formal oversight.
Among the respondents, 85% recognized that serum immunoglobulin E panels carry high false-positive rates. Furthermore, 21% of responding clinicians stated they had ordered a panel because a patient or family specifically requested it, despite current clinical guidance advising against routine use for unindicated symptoms.
| Survey Characteristic | Respondent Metric |
|---|---|
| Total Surveyed Clinicians | 300 |
| Total Survey Respondents | 43 (14% response rate) |
| Generalist Specialty Breakdown | 55% internal medicine, 27% pediatrics |
| Provider Type Breakdown | 58% physicians (MD/DO), 40% NPs or PAs |
| Mean Years in Practice | 16 years (SD, 10) |
“Most of the clinicians we surveyed already knew these tests could lead to false positive results, but many still ordered them despite current guidelines advising against their use,” said Katelyn Wong, MD, an allergist-immunologist in New Haven, Connecticut, and an ACAAI member.
“False positive results can lead families to cut out foods that were never actually unsafe, cause unnecessary stress, and add extra costs,” Wong said.
The respondent pool featured a mean of 16 years in practice with a standard deviation of 10 years. Another 44% of responding clinicians reported that they first learned about broad food allergy panels only after completing their formal medical training.
When a patient suspects an adverse food reaction, consulting a board-certified allergist-immunologist helps ensure appropriate diagnostic evaluation—such as targeted skin prick testing or double-blind placebo-controlled food challenges—rather than relying on broad screening panels that risk misclassifying food hypersensitivity.
The survey data and findings were presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
- American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, Phoenix, Arizona, November 2026.
