CSACI Position statement on the testing of food-specific IgG
Bibliographic record
Abstract
The Canadian Society of Allergy and Clinical Immunology (CSACI) is very concerned about the increased marketing of food-specific immunoglobulin G (IgG) testing towards the general public over the past few years, supposedly as a simple means by which to identify “food sensitivity”, food intolerance or food allergies. In the past, this unvalidated form of testing was usually offered by alternative or complementary health providers, but has now become more widely available with direct-to-consumer marketing through a nationwide chain of pharmacies. There is no body of research that supports the use of this test to diagnose adverse reactions to food or to predict future adverse reactions. The literature currently suggests that the presence of specific IgG to food is a marker of exposure and tolerance to food, as seen in those participating in oral immunotherapy studies. Hence, positive test results for food-specific IgG are to be expected in normal, healthy adults and children. Furthermore, the inappropriate use of this test only increases the likelihood of false diagnoses being made, resulting in unnecessary dietary restrictions and decreased quality of life. The immediate expense of the test to individuals (see below for details on cost) will be compounded by the costs incurred by an already-overburdened health care system. Confused by the information provided by IgG testing, individuals are likely to request additional specialist referrals and investigations which would otherwise not be necessary. Additionally, and perhaps of greater potential concern, a person with a true immunoglobulin E (IgE)-mediated food allergy, who is at significant risk for life-threatening anaphylaxis, may very well not have elevated levels of specific IgG to their particular allergen, and may be inappropriately advised to reintroduce this potentially deadly item into their diet. As a result of these serious and growing concerns, the CSACI has elected to issue a formal statement supporting the opinions expressed by the American Academy of Allergy Asthma and Immunology (AAAAI) [1], and by the European Academy of Allergy and Clinical Immunology (EAACI) [2]. Both of these organizations warn about the inappropriate measurement of food-specific IgG or IgG4 to suggest the presence or potential of adverse reactions to food. Recent guidelines emphasize that such testing plays no role in the diagnosis of food allergy or intolerance [3]. A recent Canadian publication also elaborates similar concerns from the perspective of community allergy practice [4]. In addition to content of all of the above documents, the CSACI is very concerned about the following issues: 1. The testing process is widely available in Canada, through a variety of complementary health providers, paramedical clinics, and some physicians. 2. A testing kit product is being sold directly to customers, in pharmacies. 3. Marketing strategies for the testing have included the placing of promotional materials in the waiting rooms of physicians without their knowledge or consent. 4. The price of the testing is often in the $400-$700 range, and some third-party payers offer reimbursement despite a clear lack of supporting evidence. 5. The test is also being marketed to concerned parents, and may lead to exclusion diets which carry risks of poor growth and malnutrition for their children: for example, the elimination of dairy products, wheat, eggs, and/or other foods found in healthy balanced diets.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.004 | 0.006 |
| Scholarly communication | 0.009 | 0.004 |
| Open science | 0.009 | 0.003 |
| Research integrity | 0.075 | 0.052 |
| Insufficient payload (model declined to judge) | 0.009 | 0.018 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".