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Cost-effectiveness of patch testing allergens within the same group: A computational approach to optimize formaldehyde-related allergen selection.
McKenzie, Ning C; Buras, Matthew R; Yiannias, James A; Hall, Matthew R; Youssef, Molly J; Davis, Mark D P; Yang, Yul W.
Afiliación
  • McKenzie NC; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
  • Buras MR; Division of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona.
  • Yiannias JA; Department of Dermatology, Mayo Clinic, Scottsdale, Arizona.
  • Hall MR; Department of Dermatology, Mayo Clinic, Jacksonville, Florida.
  • Youssef MJ; Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
  • Davis MDP; Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
  • Yang YW; Department of Dermatology, Mayo Clinic, Scottsdale, Arizona. Electronic address: yang.yul@mayo.edu.
J Am Acad Dermatol ; 91(5): 843-847, 2024 Nov.
Article en En | MEDLINE | ID: mdl-38972480
ABSTRACT

BACKGROUND:

Patch testing for multiple cross-reactive allergens for allergic contact dermatitis (ACD) may not be necessary because of copositivity.

OBJECTIVES:

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 identified which single formaldehyde-related allergen optimally captures patients with clinically relevant ACD. Next, Patch Optimization Platform determined the optimal additional 1, 2, 3, etc. allergens. Cost per patch test was $5.19 (Medicare 2022).

RESULTS:

A total of 9832 patients were tested for all listed allergens, with 830 having positive patch test results. Patch Optimization Platform 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 5 top allergens capture >94% of patients. The incremental cost per additional diagnosis increased up to 44-fold as the number of allergens tested increased.

LIMITATIONS:

Data are from a single institution, and the cost per test was fixed according to Medicare Part B in 2022.

CONCLUSIONS:

For diagnosing ACD, we recommend considering an optimized allergen selection algorithm.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pruebas del Parche / Alérgenos / Análisis Costo-Beneficio / Dermatitis Alérgica por Contacto / Formaldehído Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pruebas del Parche / Alérgenos / Análisis Costo-Beneficio / Dermatitis Alérgica por Contacto / Formaldehído Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos