title: Current practice trends in allergy: results of a united states survey of otolaryngologists, allergist-immunologists, and primary care physicians.
abstract: BACKGROUND
  Clinical practices for the diagnosis and treatment of allergic disease evolve over time in response to a variety of forces. The techniques used by various physician specialties are not clearly defined and may vary from published descriptions or recommendations in the literature.
  
  
  METHODS
  This work is a Web-based survey enrolling 250 U.S. physicians in the following specialties: otolaryngology (ENT), allergy-immunology (A/I), and primary care (PCP).
  
  
  RESULTS
  Respondents reported that skin-prick testing is the most common diagnostic testing method, followed by in vitro specific immunoglobulin E (IgE) testing. ENTs were more likely to use intradermal testing compared to other specialties (p = 0.0003 vs A/I; p < 0.0001 vs PCP). Respondents reported a wide distribution in number of allergens tested, regardless of testing method (range, 11 to >60). Significant use of home immunotherapy injections (defined as >10% of immunotherapy patients) ranged from 27% to 36% of physicians, with no statistically significant difference noted based upon specialty. PCPs reported greater use of sublingual immunotherapy (PCP, 68%; A/I, 45%; otolaryngology, 35%; A/I vs PCP, p = 0.005; ENT vs PCP p < 0.001)).
  
  
  CONCLUSIONS
  A variety of allergy testing and treatment methods are employed by U.S. physicians, with some differences noted based upon specialty. Home immunotherapy continues to be employed in allergy practices, and sublingual immunotherapy is a common form of delivery, especially in primary care practices.
authors.affiliation: Department of Otolaryngology, University of Texas (UT) Southwestern Medical Center, Dallas, TX.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Ryan
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Marple
authors.forename: Bryan
authors.initials: B
authors.lastname: Leatherman
authors.forename: J Whit
authors.initials: JW
authors.lastname: Mims
authors.forename: John
authors.initials: J
authors.lastname: Fornadley
authors.forename: Maria
authors.initials: M
authors.lastname: Veling
authors.forename: Sandra Y
authors.initials: SY
authors.lastname: Lin
mesh_terms: D000485:Allergens / Q000276:immunology*; D000486:Allergy and Immunology / Q000639:trends*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000628:therapy; D010036:Otolaryngology / Q000639:trends*; D058007:Physicians, Primary Care / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012882:Skin Tests / Q000706:statistics & numerical data; D014481:United States
chemical_list: D000485:Allergens
keywords: allergen immunotherapy; allergy; allergy testing; food allergy; home immunotherapy; sublingual immunotherapy