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The Editor takes a closer look at some of this month's articles

Sensitization does not always mean disease and in food allergy the gold standard for deciding if someone is allergic is a food challenge which is time consuming and carries a potential risk. Less invasive markers of the likelihood of symptoms in the presence of sensitization would therefore be very welcome. Most approaches have focused on the level of specific IgE or in some cases the skin prick test response, but both are far from perfect. In this deceptively simple study Tripodi and colleagues (pp. 1225–1233) found that a threshold dilution of 1 : 256 gave a remarkable sensitivity and specificity for discriminating between a positive and a negative challenge of 95% and 100%, respectively. This offers a simple and convenient alternative for the practising allergists that avoids the stress and resources required for a food challenge and provides data on which to base advice to parents who are unwilling to proceed to a challenge.