Clinicians continue ordering food allergy panels despite false positive risks

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.