Table 1. Simulation Model Inputs.
| Variable | Model Reference | Source |
|---|---|---|
| US life table | National Vital Statistics Reports, April 2017 | Arias et al,23 2017 |
| Testing characteristics | SPT (8-mm cutoff): sensitivity, 0.54 (range, 0.50 to 0.98); specificity, 0.98 (range 0.60 to 0.99) | Peters et al,17 2013 |
| Deaths due to food allergy | Aged 0-19 y, 3.25 (95% CI, 1.73 to 6.10) per 1 million person-years (sensitivity, 0.30 to 30.00); aged ≥20 y, 1.81 (95% CI, 0.94 to 3.45) per 1 million person-years (sensitivity, 1.81 to 18.10) | Umasunthar et al,19 2013 |
| Rate of accidental peanut exposure and symptoms in persons with peanut allergy | 11.7%/y (sensitivity, 5.0% to 45.0%) | Vander Leek et al,20 2000 |
| Rate of severe allergic reaction in persons with peanut allergy per year | Accidental: 52.0% (sensitivity, 1.0% to 55.0%); index introduction: 30.5% (sensitivity, 5.0% to 55.0%) | Vander Leek et al,20 2000; Osborne et al,12 2011 |
| Hospitalization rate after ED visit for severe allergic reaction | 35.0% (sensitivity, 5.0% to 45.0%) | Robinson et al,21 2017 |
| Cost of primary health care visits per year | $100 (Sensitivity, $94 to $105) | Gupta et al,27 2013; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of allergist visits for food allergy | Initial consultation for testing: $687 (sensitivity, $500 to $1200); oral food challenge; $124 (sensitivity, $100 to $600); annual follow-up visits: $149 (sensitivity, $140 to $152) | Gupta et al,27 2013; CMS,25 2017; Dartmouth-Hitchcock,26 2017; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of nutritionist visits for food allergy per year | $17 (Sensitivity, $15 to $18) | Gupta et al,27 2013; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of alternative health care professional visits for food allergy per year | $25 (Sensitivity, $22 to $27) | Gupta et al,27 2013; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Incremental cost of groceries (living with food allergy) per year | $310 (Sensitivity, $290 to $330) | Gupta et al,27 2013; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Costs of job-related opportunity due to food allergy per year | $2597 (Sensitivity, $0 to $2697) | Gupta et al,27 2013; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of personal epinephrine autoinjector | $715 (Sensitivity, $50 to $1000) | Shaker et al,29 2017; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of skin test | $24 (Sensitivity, $10 to $40) | CMS,25 2017 |
| Cost of hospitalization | $5899 (95% CI, $5732 to $6066) | Patel et al,28 2011; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Cost of ED visit | $691 (95% CI, $689 to $693) | Patel et al,28 2011; US Department of Labor, Bureau of Labor Statistics,24 2017 |
| Negative health state influence for food allergy and anaphylaxis | −0.09 (Sensitivity, −0.05 to −0.11) | Carroll and Downs,30 2009 |
| Cycle length | 1 y | NA |
| Peanut allergy pretest probability | 14.0% (Sensitivity, 14.0% to 40.0%) | Koplin et al,13 2016 |
| Annual discount rate | 0.03 (Sensitivity, 0 to 0.05) | NA |
| Probability of identifying false-positive test result during model horizon | 20.0% (Sensitivity, 5.0% to 80.0%) | NA |
Abbreviations: CMS, Centers for Medicare & Medicaid Services; ED, emergency department; NA, not applicable; SPT, skin prick test.