Why do clinicians still order food allergy panels?

Clinical takeaway: Avoid broad food allergy panels unless there is a clear, guideline-supported indication. Positive panel results can reflect sensitization rather than true food allergy, potentially leading to unnecessary food avoidance, anxiety, and additional healthcare use.

Professional allergy societies advise against routine broad food allergy panel testing because of high false-positive rates and the risk of overdiagnosis. Yet such panels remain common in practice, with more than 1,700 ordered in a single hospital system in 2024.

Many clinicians recognize the limitations of broad food allergy panels but continue to order them, according to survey findings presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2026 Annual Scientific Meeting. The findings have not yet undergone peer review.

Investigators surveyed 300 clinicians who had ordered at least one food allergy panel in 2024 and received responses from 43. Most respondents were generalists, including internal medicine and pediatric clinicians, and 58% were physicians while 40% were nurse practitioners or physician assistants.

Although 85% of respondents acknowledged that food allergy panels have high false-positive rates, many reported ordering them for reasons not supported by expert recommendations. Clinicians identified urticaria (29%) and eczema (14%) as appropriate indications, despite guidelines discouraging panel testing in such settings.

Among reasons for prior ordering, 24% cited suspected IgE-mediated food allergy, 21% cited patient or family request, and 20% cited urticaria. In a survey scenario involving eczema and a family history of food allergy, 63% of nurse practitioners and physician assistants said a food allergy panel would be indicated, compared with 30% of physicians.

The authors concluded that important knowledge gaps remain regarding appropriate use of food allergy panels and suggested that targeted education could help reduce unnecessary testing. As senior author Katelyn Wong, MD, noted, “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.”

Source: Nguyen M, et al. (2026 Nov 12). American College of Allergy, Asthma and Immunology Annual Scientific Meeting. Exploring Ordering Clinicians’ Perspectives of Food Allergy Panels