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In daily clinical practice, it is not so easy to make a confirmative diagnosis of food allergy. Interpretation of skin prick test and serum food-specific IgE (sIgE) test results is influenced by detailed clinical history of an individual patient, but ingested foods which provoke adverse reactions often contain many ingredients and lead to a misdiagnosis of food allergy. Oral food challenge is recommended for the diagnosis of food allergy, but we cannot always perform oral food challenge for various reasons, including recent severe reactions to food, severe atopic dermatitis, patient' and/or parents' refusal and noncooperation of young patients. Thus, from the physician's point of view, cutoff values of sIgE titers that provide high positive and negative predictive values would be very useful in clinical settings because they help determine which patient is more likely to have symptoms in response to a certain food and which are probably nonreactive.

Diagnostic Decision Points of Specific IgE Titers in Patients With Food Allergy: Are They Appropriate in All Clinical Settings?