PMID- 31828183
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2333-794X (Electronic)
IS  - 2333-794X (Linking)
VI  - 6
DP  - 2019
TI  - Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the 
      Diagnosis of Children With Food Allergy.
PG  - 2333794X19891298
LID - 10.1177/2333794X19891298 [doi]
LID - 2333794X19891298
AB  - Introduction. Food allergies affect 8% of the pediatric population in the United 
      States with an estimated annual cost of US$25 billion. The low specificity of 
      some of the main food allergy tests used in diagnosis may generate false 
      positives incurring unnecessary costs. We examined the cost-effectiveness of oral 
      food challenges (OFC) as confirmatory tests in the diagnosis of food allergy. 
      Methods. We constructed a decision tree with a Markov model comparing the 
      long-term (15 years) cost and effectiveness-in the form of quality-adjusted life 
      years (QALY)-of confirmatory OFCs compared with immediate allergenic food 
      elimination (FE) after a skin prick test or blood immunoglobulin E (IgE) level in 
      children with suspected food allergy. For costs, we included the costs of OFCs 
      and the reported annual costs of having a food allergy, including direct medical 
      costs and costs borne by families. Results. The cost of OFC strategy was $8671 
      compared with $18 012 for the FE strategy for the length of the model. Also, the 
      OFC strategy had a total QALY of 21.942 compared with 21.740 for the FE strategy. 
      In the OFC strategy, the total cost was $9341 less than FE and the increase in 
      QALY after OFCs led to a 0.202 higher effectiveness in the OFC strategy. 
      Conclusion. In conclusion, our study shows that the confirmatory OFC strategy 
      dominated the FE strategy and that a confirmatory OFC for children, within a year 
      of diagnosis, is a cost-effective strategy that decreases costs and appears to 
      improve quality of life.
CI  - (c) The Author(s) 2019.
FAU - Alsaggaf, Abdullah
AU  - Alsaggaf A
AD  - University of California San Diego, La Jolla, CA, USA.
FAU - Murphy, James
AU  - Murphy J
AD  - University of California San Diego, La Jolla, CA, USA.
FAU - Leibel, Sydney
AU  - Leibel S
AUID- ORCID: 0000-0001-9857-7657
AD  - University of California San Diego, La Jolla, CA, USA.
AD  - Rady Children's Hospital San Diego, San Diego, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20191129
PL  - United States
TA  - Glob Pediatr Health
JT  - Global pediatric health
JID - 101670224
PMC - PMC6886273
OTO - NOTNLM
OT  - cost-effectiveness
OT  - food allergy
OT  - oral food challenge
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2019/12/13 06:00
MHDA- 2019/12/13 06:01
PMCR- 2019/11/29
CRDT- 2019/12/13 06:00
PHST- 2019/08/29 00:00 [received]
PHST- 2019/10/31 00:00 [revised]
PHST- 2019/11/06 00:00 [accepted]
PHST- 2019/12/13 06:00 [entrez]
PHST- 2019/12/13 06:00 [pubmed]
PHST- 2019/12/13 06:01 [medline]
PHST- 2019/11/29 00:00 [pmc-release]
AID - 10.1177_2333794X19891298 [pii]
AID - 10.1177/2333794X19891298 [doi]
PST - epublish
SO  - Glob Pediatr Health. 2019 Nov 29;6:2333794X19891298. doi: 
      10.1177/2333794X19891298. eCollection 2019.