Clinicians know food allergy panels can lead to overdiagnosis — but order them anyway

PHOENIX (Nov. 12, 2026) – New research being presented at the 2026 Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology (ACAAI) showed many clinicians in a survey knew that food allergy panel testing often results in false positives— yet they kept ordering it anyway.

Food allergy panel testing checks a person's blood for allergic proteins produced by the immune system, or immunoglobulin E antibodies, to many foods at once. These commercially available panels frequently come back with "false positives," indicating the presence of allergic proteins, or sensitization, to foods even when a clinical food allergy may not exist.

"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 allergist-immunologist Katelyn Wong, MD, senior author of the study and ACAAI member. "False positive results can lead families to cut out foods that were never actually unsafe, cause unnecessary stress, and add extra costs. At one hospital system alone, more than 1,700 of these panels were ordered in a single year.”

Researchers surveyed 300 clinicians who  ordered at least one food allergy panel in 2024. Forty-three completed the anonymous survey, most of them primary care doctors, nurse practitioners, and physician assistants.

Several findings stood out:

• 85% of clinicians  knew these panels often give false positive results — but ordered them anyway.
• Many clinicians had ordered food allergy panels for unvalidated indications such as food allergies, hives, and eczema.
• Some clinicians had ordered the test simply because a patient or family asked for it, not because it was medically needed.
• In one survey question about a patient with eczema and a family history of food allergy, nurse practitioners and physician assistants were more likely than physicians to think a food allergy panel was the right choice, even though experts do not recommend this.

The gap between knowing the downsides of the panels and knowing expert recommendations may help explain why these panels are ordered so often, even though experts advise against them.

When a food allergy panel has a false positive result, families may end up avoiding foods that were never actually a problem. This can make mealtimes stressful, limit a child's diet without reason, and add worry the family didn't need. It can also mean additional  visits and unnecessary costs. Moreover, avoidance of food allergens can increase the risk of developing food allergies.

Abstract Title: Exploring Ordering Clinicians’ Perspectives of Food Allergy Panels

Presenter: Mai Nguyen, MD, PhD

For more information about diagnosis and treatment of food allergies, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 12-16. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI26.

About ACAAI

The American College of Allergy, Asthma & Immunology (ACAAI) is a professional medical organization of more than 6,500 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. Founded in 1942, the College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Instagram, Threads and X.

EXPLORING ORDERING CLINICIANS’ PERSPECTIVES OF FOOD ALLERGY PANELS
R285
M. Nguyen^*, K. Brady, K. Wong, New Haven, CT.

Introduction: Broad food allergy (FA) panels are over-ordered for unvalidated indications, with over 1,700 ordered at our institution in 2024. Professional societies advise against their use due to the negative consequences of unnecessary food avoidance, psychological stress, and financial burden. This study aimed to elucidate ordering clinicians’ rationale and understanding of these panels.

Methods: 300 clinicians who had ordered at least one FA panel in 2024 were contacted via email or Epic message to participate in a voluntary, anonymous survey. Results were analyzed using Qualtrics and Prism. This study was exempted by IRB.

Results: 43 clinicians completed the survey. Most were generalists (55% internal medicine, 27% pediatrics) and physicians (MD/DO 58% vs NP/PA 40%). The mean length of practice was 16 years (standard deviation=10). Most learned about FA panels after training (44%). 85% recognized that FA panels have high false positive rates. Clinicians reported appropriate FA panel indications included IgE-mediated FA (38%), urticaria (29%) and eczema (14%). Clinicians had previously ordered FA panels for IgE-mediated FA (24%), patient/family request (21%), and urticaria (20%). When asked to evaluate eczema triggers in a patient with family history of FA, 30% of MD/DOs and 63% of NP/PAs agreed that FA panel would be indicated (Χ² (1, N = 43) = 3.946, p = 0.047).

Conclusion: This survey identified knowledge gaps regarding appropriate indications for FA panels despite awareness of high false positive rates, suggesting that targeted educational efforts may prove helpful to reduce the use of FA panels.