Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis

Matthew Greenhawt, Marcus Shaker, Julie Wang, John J. Oppenheimer, Scott Sicherer, Corinne Keet, Keri Swaggart, Matthew Rank, Jay M. Portnoy, Jonathan Bernstein, Derek K. Chu, Chitra Dinakar, David Golden, Carolyn Horner, David M. Lang, Eddy S. Lang, David A. Khan, Jay Lieberman, David Stukus, Dana Wallace

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Given the burden of disease and the consequences of a diagnosis of peanut allergy, it is important that peanut allergy be accurately diagnosed so that an appropriate treatment plan can be developed. However, a test that indicates there is peanut sensitization present (eg, a “positive” test) is not always associated with clinical reactivity. This practice parameter addresses the diagnosis of IgE-mediated peanut allergy, both in children and adults, as pertaining to 3 fundamental questions, and based on the systematic reviews and meta-analyses, makes recommendations for the clinician who is evaluating a patient for peanut allergy. These questions relate to when diagnostic tests should be completed, which diagnostic tests to utilize, and the utility (or lack thereof) of diagnostic testing to predict the severity of a future allergic reaction to peanut.

Original languageEnglish
Pages (from-to)1302-1334
Number of pages33
JournalJournal of Allergy and Clinical Immunology
Issue number6
StatePublished - Dec 2020


  • Ara h 2
  • GRADE analysis
  • Peanut allergy
  • cost-effectiveness analysis
  • diagnosis
  • evidence to recommendation
  • likelihood ratio
  • meta-analysis
  • peanut components
  • practice parameter update
  • serologic IgE testing
  • skin prick testing
  • systematic review


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