Abstract
A questionnaire survey was conducted among 376 members of the West Japan Research Society of Pediatric Clinical Allergy and Shikoku Research Society of Pediatric Clinical Allergy. A response was requested from each of the 324 facilities in order to assess the state of implementation and safety, etc. of oral challenge testing for food allergies. The response rate was 50% (163 hospitals and clinics) including 72% (63) of hospitals and 42% (100) of clinics and 63/100 responses from allergy specialists/general pediatricians. A total of 74% of the specialists implemented challenge testing compared to 38% of the generalists. Regarding the average number of times administered, 57% of the specialists reposted a rate of 1-5 tests, while 28% reported a rate of 11 tests or more among outpatients. In contrast, 85% of the general pediatricians reported a rate of 1-5 tests. Only 40% of the specialists and 23% of the generalists implemented testing among inpatients. Medical service fees were charged by 85% of the specialists, compared to only 38% of the generalists. The reasons given for the lack of testing included "difficulties in ensuring the staff, venue and time necessary to implement the tests", and "the risk of an immediate reaction" from the generalists, and "limits by health insurance regulations in the number of challenge tests and the age of patients who able to receive the tests" from the specialists. In order to ensure that a greater number of children safety receive challenge testing, both the establishment of a training system for specialists and the simultaneous expansion of the adaptive criteria for challenge testing implemented by specialists are required.
