The first article in this series discussed the importance of properly designed clinical trials to validate various diagnostic and therapeutic procedures and also described clinically accepted and proved tests. This article discusses other challenge tests and unproved procedures. The value of provocation-neutralization procedures has been controversial; two promising clinical models have been developed that may allow definitive trials of efficacy. Immunotherapy with allergenic extracts has been shown to be a safe and effective procedure in carefully selected patients treated with potent, well-standardized antigens administered in adequate dosage. It has been proposed that many nonspecific signs or symptoms could be caused by exposure to Candida albicans or low-dose environmental substances. The cause-and-effect relationships between exposure to C albicans or other environmental substances and the disorders that are alleged to be associated with them are, for the most part, unproved.
In Vivo Diagnostic Testing and Immunotherapy for AllergyReport I, Part II, of the Allergy Panel. JAMA. 1987;258(11):1505–1508. doi:10.1001/jama.1987.03400110087031