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Cost-effectiveness of patch testing allergens within the same group: A computational approach to optimize
Ning C McKenzie1, Matthew R Buras2, James A Yiannias3
1Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
Journal of the American Academy of Dermatology
|July 7, 2024
Summary
Testing fewer formaldehyde allergens for allergic contact dermatitis (ACD) is effective and cost-efficient. A select few allergens can identify most cases, reducing unnecessary testing and costs.
Area of Science:
- Dermatology
- Allergology
- Immunology
Background:
- Allergic contact dermatitis (ACD) diagnosis often involves testing multiple cross-reactive allergens.
- Copositivity among certain allergens suggests that extensive testing may not always be necessary.
Purpose of the Study:
- To evaluate formaldehyde group allergens for optimal and cost-effective patch testing.
- To identify the most efficient allergen panel for diagnosing formaldehyde-related ACD.
Main Methods:
- Retrospective analysis of 9832 patients tested for formaldehyde group allergens at Mayo Clinic (1997-2022).
- Utilized the Patch Optimization Platform to identify optimal single and multiple allergen combinations.
- Calculated cost per patch test based on Medicare data ($5.19).
Main Results:
- Quaternium 15 alone identified 53% of ACD cases within the formaldehyde group.
- Adding formaldehyde (1%) as a second allergen increased detection to 78%.
- The top 5 optimized allergens captured over 94% of relevant ACD cases, with significant cost increases for additional allergens.
Conclusions:
- An optimized allergen selection algorithm can improve diagnostic efficiency for ACD.
- Selective testing of formaldehyde allergens can be more cost-effective than broad screening.
- Further validation from single-institution data is noted.
