RAST analyses were performed with house dust, animal dander and eleven pollen allergens in 410 adult patients with asthma and/or rhinitis and the findings were compared with skin test and provocation test results. The overall correlation between 1,316 provocation tests and RAST was 78% and the correlation between 1,778 skin tests and RAST was 66%. The relationships between RAST and in vivo tests differed considerably from allergen to allergen. No significant differences were found between various age groups. According to the in vivo tests the RAST showed more often positive results in patients with pronounced allergy than in patients with low-grade allergy. Higher RAST classes were most often combined with positive in vivo tests. It is concluded that in cases with RAST classes 2–4, a reasonably well-established allergy diagnosis can be reached without the inclusion of additional in vivo tests. In other cases, however, application of further diagnostic methods is required.

In a multi-centre study, comprising 16 clinics, 871 adult hay fever patients were studied. Most patients included had springtime hay fever. Skin prick tests were performed with 20 different tree or bush pollen (lignoses) allergens. RAST determinations were done with eight different tree pollen allergens in 590 patients. Birch pollen (BP) allergen gave the highest frequency of positive test results. The test results with the various tree pollen allergens in patients with BP allergy were compared with those in patients without BP allergy. With all the allergens a significantly higher frequency of positive test results was found in those with BP allergy than in those without. Only very small differences were noted between various parts of the country, and sensitization against various tree pollens was common even in regions where the corresponding trees do not grow. It was concluded that a high degree of cross-sensitization exists among tree pollens, and testing with BP allergen is sufficient for the diagnostic screening of tree pollen allergy.

The distribution of trees and bushes in Sweden (viz. lignoses) of possible allergic importance is presented and comments made on analyses of pollen counts of lignose taxa from different parts of the country. Based on these data, 20 lignose taxa were selected for an allergen panel and used in a multi-centre study covering Sweden with the aim of revealing the pattern of sensitization to these plants among sufferers of springtime hay fever.

With the assumption that a provocation test gives the correct diagnosis, the possibility of predicting an allergy by means of the case history, a skin test, radioallergosorbent test (RAST) and combinations of these methods was evaluated for house dust, cow-, cat-, dog- and horse-dander, timothy-, marguerite-, dandelion- and birch-pollen allergens. All procedures were found to give a reliable diagnosis provided that a group with doubtful diagnosis was interposed between the negative and the positive ones. The doubtfoul group, requiring further diagnostic investigations, was smallest when all three methods were used in combination. It is suggested that, in addition to the case history, the first procedure in routine diagnosis with inhalant allergens should be a skin test. RAST should be used primarily for selected cases and as a complement to the case history and skin test, making provocation tests superfluous for the majority of patients.

Case histories alone and combined with the results of skin tests and/or the radioallergosorbent test (RAST) were compared with the results of provocation tests in 397 patients with asthma or allergic rhinitis. Case histories often turned out to be doubtful. The agreement between negative histories and negative provocation tests was 77% and that between positive histories and positive provocation tests 64%. When case histories were supported by concordant skin test or RAST results, the agreement with provocation tests increased to about 90%. When a scoring system for the combinations of different diagnostic methods was employed, a 100% agreement with provocation tests was obtained for cases with high scores. It is concluded that by using the case history in conjunction with RAST and/or skin test results, a reliable diagnosis can be achieved, eliminating the necessity of provocation tests.