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Review Article |
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Methodological Issues in the
Diagnostic Work-up of Food Allergy: A Real Challenge |
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M Gellerstedt,1 U
Bengtsson,2 B Niggemann3 |
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1 Department of Informatics,
University West, Trollhättan, Sweden
2 The Asthma and Allergy Research Group, Department of
Respiratory Medicine and Allergy, Sahlgrenska University
Hospital, Gothenburg, Sweden
3 Department of Pneumology and Immunology, University
Children’s Hospital Charité, Berlin, Germany |
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J Investig Allergol Clin Immunol
2007; Vol. 17 (6): 350-356 |
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Abstract |
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The standard of
reporting in
diagnostic studies
has generally been
low. Fortunately,
this issue has begun
to be addressed in
recent years through
the discussion of
important
methodological
issues in
educational series,
textbooks, and
checklists. Double-blind,
placebocontrolled,
oral food challenges
(DBPCFC) are
considered to be the
gold standard for
diagnosis of food
allergy. However,
there is no
consensus regarding
how to interpret the
outcome and how to
define positive and
negative
provocations in
DBPCFC. Furthermore,
since most theories
on the diagnosis of
food allergy rely on
the assumption that
the DBPCFC has a
high accuracy, this
accuracy must be
formally
statistically
evaluated.
In this review, we
discuss essential
methodological
issues for
diagnostic accuracy
studies in general
and for oral food
challenges in
particular and
discuss the
importance of
methodological
issues as a guide
for forthcoming
studies of
diagnostic
procedures.
Key words:
Diagnostic accuracy.
Food allergy. Food
challenge.
Methodological
issues.
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