What type of food allergy test is more accurate?

Scratch and patch: Scratch and patch testing are currently the gold standards for allergy testing. The results need to be correlated with symptoms and properly interpreted by a qualified physician.

Depends...: For immediate, ige, mediated reactions, the gold standard is percutaneous (prick) skin testing. Serum rast testing which quantifies the amount of the ige is also useful but not as sensitive as percutaneous testing. Patch testing is reserved for specific conditions such as eosinophilic esophagitis and is used to detect delayed, cell-mediated food hypersensitivity. This test has a low sensitivity.

A food challenge: Although most food allergies are diagnosed by taking a good history of the reaction and performing an allergy skin test in the office, it is possible to have a positive skin test and but not be allergic to the food. The definitive evaluation of food allergy is by carefully administering small amounts of the food in an allergy office in a monitored setting.

Neither: Skin testing and blood test (serum specific ige) have different sensitivities and specificities. Either or both must be interpretted in light of the clinical picture. Frequently, patients with positive tests are not allergic and an oral challenge under the supervision of a board certified allergist familiar with oral challenges and treatment of anaphylaxis is needed.

Blood test: The skin test is more sensitive -- so there is less chance of you missing a real allergy. The blood test is more accurate, but it comes at a price of potentially missing a relevant allergy. Using both tests in combination with a clinical history will give you the best sensitivity and accuracy.

"double blind": Double blind challenge is most accurate = the gold standard. But skin testing is very accurate as well. Blood tests are helpful in some cases.

Percutaneous : Skin testing is the most sensitive.