{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:19:51Z","timestamp":1788959991864,"version":"build-2803163510"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Rationale<\/jats:title>\n<jats:p>Food allergy is documented to result in considerable morbidity, negative impact on quality of life, and substantial medical care costs. Although anecdotal data suggest widely varying practices in the diagnosis and management of food allergies, the diversity and relative frequency of these practices have not been documented.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A questionnaire was developed evaluating allergists\u2019 management approaches of individuals with peanut allergy (PA) in Germany (DE), France (FR), and the United Kingdom (UK).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Here, we report the survey results from a total of 109 allergists from DE, FR and the UK. They reported to confirm PA at initial diagnosis using skin prick test (\u226560%), while allergists from DE and FR reported using allergen-specific IgE testing more (&gt;86%) compared to the UK (&lt;50%). At initial diagnosis, oral food challenge was used less in DE (13%) and FR (14%) and very rarely in the UK (3%) to confirm diagnosis. Recognition of acute reactions, use of adrenaline auto-injectors and allergen avoidance were reported to be discussed with the patient\/caregiver at the initial office visit by most allergists (&gt;75%). Half of the responders reported assessing the patient\u2019s quality of life. 63% allergists reported retesting for PA resolution at a later date, with 45% allergists indicated to recommend ingestion of a normal serving of peanut regularly upon resolution. Lack of effective PA treatment was reported to be a \u2018very significant\u2019 barrier for optimal PA treatment, with allergists being less than \u2018moderately familiar\u2019 with data from clinical trials testing new treatments options for PA. Lastly, allergists stated that the severity of patient\u2019s PA ranked as the most important factor in their decision to recommend oral immunotherapy for PA treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This survey provides essential insights into the practice of allergists and highlights some areas that would inform strategies for education and improving PA healthcare.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0241648","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T18:44:33Z","timestamp":1607021073000},"page":"e0241648","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["A study to assess current approaches of allergists in European countries diagnosing and managing children and adolescents with peanut allergy"],"prefix":"10.1371","volume":"15","author":[{"given":"Vibha","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Jobrack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Cerenzia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Tilles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0827-3153","authenticated-orcid":true,"given":"Robert","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Sih-Meynier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zeitler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-7356","authenticated-orcid":true,"given":"Michael","family":"Manning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"key":"pone.0241648.ref001","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jaci.2017.11.003","article-title":"Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management","volume":"141","author":"SH Sicherer","year":"2018","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"pone.0241648.ref002","article-title":"Frequency of food allergy in school-aged children in eight European countries\u2013the EuroPrevall-iFAAM birth cohort","author":"L Grabenhenrich","year":"2020","journal-title":"Allergy"},{"key":"pone.0241648.ref003","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/all.12305","article-title":"The epidemiology of food allergy in Europe: a systematic review and meta-analysis","volume":"69","author":"BI Nwaru","year":"2014","journal-title":"Allergy"},{"key":"pone.0241648.ref004","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1067\/mpd.2000.109376","article-title":"The natural history of peanut allergy in young children and its association with serum peanut-specific IgE","volume":"137","author":"TK Vander Leek","year":"2000","journal-title":"J Pediatr"},{"key":"pone.0241648.ref005","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.pcl.2015.07.009","article-title":"Diagnosis of Food Allergy","volume":"62","author":"RS Chinthrajah","year":"2015","journal-title":"Pediatr Clin North Am"},{"key":"pone.0241648.ref006","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1038\/nri.2016.111","article-title":"Food allergy: immune mechanisms, diagnosis and immunotherapy","volume":"16","author":"W Yu","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"pone.0241648.ref007","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1111\/all.13717","article-title":"Food-related anaphylaxis fatalities: Analysis of the Allergy Vigilance Network \u00ae database","volume":"74","author":"G Pouessel","year":"2019","journal-title":"Allergy"},{"key":"pone.0241648.ref008","first-page":"46","article-title":"Loveren H van. Parameters Needed to Estimate the Global Burden of Peanut Allergy: Systematic Literature Review","author":"J Ezendam","year":"2012","journal-title":"European Journal of Nutrition & Food Safety"},{"key":"pone.0241648.ref009","article-title":"APPEAL-1: A multiple-country European survey assessing the psychosocial impact of peanut allergy","author":"A DunnGalvin","journal-title":"Allergy"},{"key":"pone.0241648.ref010","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1007\/s40629-015-0074-0","article-title":"Guidelines on the management of IgE-mediated food allergies: S2k-Guidelines of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Medical Association of Allergologists (AeDA), the German Professional Association of Pediatricians (BVKJ), the German Allergy and Asthma Association (DAAB), German Dermatological Society (DDG), the German Society for Nutrition (DGE), the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery, the German Society for Pediatric and Adolescent Medicine (DGKJ), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Society for Pneumology (DGP), the German Society for Pediatric Gastroenterology and Nutrition (GPGE), German Contact Allergy Group (DKG), the Austrian Society for Allergology and Immunology (\u00c6-GAI), German Professional Association of Nutritional Sciences (VDOE) and the Association of the Scientific Medical Societies Germany (AWMF)","volume":"24","author":"M Worm","year":"2015","journal-title":"Allergo J Int"},{"key":"pone.0241648.ref011","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/all.13319","article-title":"EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy","volume":"73","author":"GB Pajno","year":"2018","journal-title":"Allergy"},{"key":"pone.0241648.ref012","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s11882-020-00908-6","article-title":"Peanut Oral Immunotherapy: a Current Perspective","volume":"20","author":"M Patrawala","year":"2020","journal-title":"Curr Allergy Asthma Rep"},{"key":"pone.0241648.ref013","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.jaci.2016.04.016","article-title":"Impact of peanut consumption in The LEAP Study: feasibility, growth and nutrition","volume":"138","author":"M Feeney","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"pone.0241648.ref014","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.anai.2019.03.034","article-title":"Pediatricians underestimate parent receptiveness to early peanut introduction","volume":"122","author":"M Lai","year":"2019","journal-title":"Annals of Allergy, Asthma & Immunology"},{"key":"pone.0241648.ref015","first-page":"1279","article-title":"Peanut allergy: an overview","volume":"168","author":"S Al-Muhsen","year":"2003","journal-title":"CMAJ"},{"key":"pone.0241648.ref016","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/j.1365-2222.2004.1923.x","article-title":"Relevance of Ara h1, Ara h2 and Ara h3 in peanut-allergic patients, as determined by immunoglobulin E Western blotting, basophil\u2013histamine release and intracutaneous testing: Ara h2 is the most important peanut allergen. Clinical &","volume":"34","author":"SJ Koppelman","year":"2004","journal-title":"Experimental Allergy"},{"key":"pone.0241648.ref017","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1111\/cea.12957","article-title":"BSACI guideline for the diagnosis and management of peanut and tree nut allergy","volume":"47","author":"G Stiefel","year":"2017","journal-title":"Clin Exp Allergy"},{"key":"pone.0241648.ref018","doi-asserted-by":"crossref","first-page":"139","DOI":"10.2174\/1573396314666180423105842","article-title":"Advances in Food Allergy Diagnosis","author":"J Gomes-Belo","year":"2018","journal-title":"Current Pediatric Reviews"},{"key":"pone.0241648.ref019","article-title":"Oral Food Challenge","volume":"55","author":"M Calvani","year":"2019","journal-title":"Medicina (Kaunas)"},{"key":"pone.0241648.ref020","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.jaci.2014.05.013","article-title":"Food allergy: A practice parameter update\u20142014","volume":"134","author":"HA Sampson","year":"2014","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"pone.0241648.ref021","first-page":"375","article-title":"Diagnosing Peanut Allergy with Fewer Oral Food Challenges","volume":"7","author":"JJ Koplin","year":"2019","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"},{"key":"pone.0241648.ref022","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1111\/cea.12788","article-title":"BSACI guideline: prescribing an adrenaline auto-injector","volume":"46","author":"P Ewan","year":"2016","journal-title":"Clinical & Experimental Allergy"},{"key":"pone.0241648.ref023","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/all.13134","article-title":"Results of an allergy educational needs questionnaire for primary care","volume":"72","author":"D Ryan","year":"2017","journal-title":"Allergy"},{"key":"pone.0241648.ref024","article-title":"The Natural History of Food Allergy. In: The journal of allergy and clinical immunology. In practice","author":"J Savage","year":"2016","journal-title":"J Allergy Clin Immunol Pract"},{"key":"pone.0241648.ref025","doi-asserted-by":"crossref","first-page":"290","DOI":"10.2500\/aap.2019.40.4240","article-title":"Peanut allergy: Burden of illness","volume":"40","author":"M Shaker","year":"2019","journal-title":"allergy asthma proc"},{"key":"pone.0241648.ref026","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/1710-1492-4-4-139","article-title":"Peanut Allergy: An Overview","volume":"4","author":"N Al-Ahmed","year":"2008","journal-title":"Allergy, Asthma & Clinical Immunology"},{"key":"pone.0241648.ref027","first-page":"250","article-title":"Immunotherapy for Food Allergy: Are We There Yet?","volume":"5","author":"Y Gernez","year":"2017","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"},{"key":"pone.0241648.ref028","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa1812856","article-title":"AR101 Oral Immunotherapy for Peanut Allergy","author":"The PALISADE Group of Clinical Investigators","year":"2018","journal-title":"New England Journal of Medicine"},{"key":"pone.0241648.ref029","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1016\/S0140-6736(19)30420-9","article-title":"Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety","volume":"393","author":"DK Chu","year":"2019","journal-title":"The Lancet"},{"key":"pone.0241648.ref030","first-page":"659","article-title":"Adverse events associated with peanut oral immunotherapy in children\u2013a systematic review and meta-analysis","volume":"10","author":"LE Grzeskowiak","journal-title":"Sci Rep. 2020"},{"key":"pone.0241648.ref031","doi-asserted-by":"crossref","first-page":"2180","DOI":"10.1016\/S0140-6736(19)30767-6","article-title":"Peanut oral immunotherapy: balancing benefits and risks for individuals","volume":"393","author":"G Roberts","year":"2019","journal-title":"The Lancet"},{"key":"pone.0241648.ref032","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.anai.2013.09.026","article-title":"Allergists\u2019 self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma, and Immunology member survey","volume":"111","author":"S Fineman","year":"2013","journal-title":"Annals of Allergy, Asthma & Immunology"},{"key":"pone.0241648.ref033","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.anai.2018.08.019","article-title":"Shared decision making for the allergist","volume":"122","author":"MS Blaiss","year":"2019","journal-title":"Annals of Allergy, Asthma & Immunology"},{"key":"pone.0241648.ref034","first-page":"46","article-title":"The Role of Shared Decision Making in Pediatric Food Allergy Management","volume":"8","author":"A Anagnostou","year":"2020","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0241648","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T18:44:41Z","timestamp":1607021081000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0241648"}},"subtitle":[],"editor":[{"given":"Davor","family":"Plavec","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,3]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0241648","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,3]]}}}