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Controversial practices in allergy

M H Grieco

    JAMA
    |June 11, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Several allergy testing methods lack scientific support. Controlled studies show intracutaneous titration, provocative testing, and autogenous urine immunotherapy are ineffective or harmful, impacting patient care and costs.

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    Area of Science:

    • Immunology
    • Clinical Allergy

    Background:

    • Modern allergy practice relies on understanding hypersensitivity pathogenesis.
    • Certain clinical practices in allergy remain controversial despite scientific scrutiny.

    Purpose of the Study:

    • To evaluate the scientific evidence supporting controversial allergy diagnostic and therapeutic procedures.
    • To inform physicians about the efficacy and risks of unproven allergy treatments.

    Main Methods:

    • Review of controlled studies examining specific allergy testing and immunotherapy modalities.
    • Assessment of evidence for intracutaneous titration, provocative testing, and autogenous urine immunotherapy.

    Main Results:

    • Controlled studies do not support intracutaneous titration or low-level modified radioallergosorbent titration for immunotherapy guidance.

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  • Evidence does not support the clinical usefulness of provocative testing or leukocytotoxicity assays for food allergy diagnosis.
  • Food additives' influence on hyperkinesis is unclear; autogenous urine immunotherapy lacks evidence and may be harmful.

    • Conclusions:

    • Physicians must understand the scientific basis of allergy procedures to advise patients effectively.
    • Controversial practices in allergy lack empirical support and may pose risks.
    • Informed patient counseling is crucial due to the prevalence and economic impact of allergic diseases.