A bstract Among the many methods ofallergy diagnosis are intradermal testing (/DT) and skin-prick testing (SPT). The usefulness of /DT has been called into question by some authors, while others believe that studies demonstrating that SPT was superior might have been subje ct to bias. We conducted a study to compare the validity ofSPT and IDT-specifically, the skin endpoint titration (SET) type of /DT-in diagnosing allergic rhinitis. We performed nasal provocation testing on 62 pati ents to establish an unbiased screening criterion f or study entry. Acoustic rhinometric measurements of the nasal responses revealed that 34 patients tested positive and 28 negative. All patients were subsequently tested by SET and SPT. We found that SPT was more sensitive (85.3 vs 79.4%) and more spec ific (78.6 vs 67.9%) than SET as a screening procedure. The pos itive predictive value of SPT was greater than that of SET (82.9 vs 75.0%), as was the negative predictive value (8/ .5 vs 73.0%). None of these differences was statistically significant; because of the relatively small sample size, our study was powered to show only equivalency. The results of our study suggest that the information obtained by the SET method of /DT is comparable to that obtained by SPT in terms ofsensitivity, specific ity, and overall performance and that both
The 2 in vitro testing systems are comparable for most of the allergens, except for A fumigatus, English plantain, lamb's-quarter, and white ash tree; ImmunoCAP and HY*TEC would benefit from improved technology for detecting these specific IgE antibodies. The HY*TEC assay did not give acceptable results for A fumigatus. The overall assay characteristics were good to excellent for each system tested.
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