Cost-effectiveness of patch testing allergens within the same group - a computational approach to optimize formaldehyde-related allergen selection.
J Am Acad Dermatol
; 2024 Jul 05.
Article
em En
| MEDLINE
| ID: mdl-38972480
ABSTRACT
BACKGROUND:
Patch testing to multiple cross reactive allergens for allergic contact dermatitis (ACD) may not be necessary due to copositivity.OBJECTIVE:
We evaluated the formaldehyde group allergens to determine the optimal, most cost-effective allergens to test.METHODS:
A retrospective analysis of Mayo Clinic (1997-2022) examined the well-established copositive formaldehyde group Formaldehyde, Quaternium 15, Hexahydro-1,3,5-tris(2-hydroxyethyl)triazine, Diazolidinyl urea, Imidazolidinyl urea, Toluenesulphonamide formaldehyde resin, DMDM hydantoin, and Ethyleneurea melamine formaldehyde mix. Patch Optimization Platform (POP) identified which single formaldehyde-related allergen optimally captures patients with clinically relevant ACD. Next, POP determined the optimal additional 1, 2, 3, etc. allergens. Cost per patch test was $5.19 (Medicare 2022).RESULTS:
9832 patients were tested to all listed allergens, with 830 having positive patch tests. POP determined that Quaternium 15 alone captures 53% of patients with ACD to the formaldehyde group; adding the optimal second allergen (Formaldehyde 1%) captures 78%; the optimal five top allergens capture over 94% of patients. The incremental cost-per-additional-diagnosis increased up to 44-fold as the number of allergens tested increased.LIMITATIONS:
Data is from a single institution, and the cost-per-test was fixed to Medicare Part B in 2022.CONCLUSIONS:
For diagnosing ACD, we recommend considering an optimized allergen selection algorithm.
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MEDLINE
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En
Ano de publicação:
2024
Tipo de documento:
Article