Probability curves focusing on symptom severity during an oral food challenge

Increasing specific immunoglobulin E levels correlate with the risk of anaphylaxis during an oral food challenge

“…The present study is the first to determine that a higher sIgE level produced in response to causative foods is a risk factor for an anaphylactic reaction during an OFC among OFC‐positive patients. The present study also confirmed that a higher sIgE level produced in response to causative foods is a risk factor for an anaphylactic reaction among all patients who undergo an OFC, consistent with previous studies . Several studies have shown that the severity of symptoms during an OFC is associated with higher sIgE levels for the causative foods .…”

“…The present study also confirmed that a higher sIgE level produced in response to causative foods is a risk factor for an anaphylactic reaction among all patients who undergo an OFC, consistent with previous studies . Several studies have shown that the severity of symptoms during an OFC is associated with higher sIgE levels for the causative foods . However, in these studies, OFC‐negative patients and OFC‐positive patients were compared and severe OFC‐induced symptoms were rare.…”

“…A history of anaphylaxis to causative foods, being older, and having an allergy to food other than eggs were reported as risk factors for a severe reaction during a double‐blind placebo‐controlled food challenge (DBPCFC) . In addition, higher specific immunoglobulin E (sIgE) levels to causative foods have been associated with a positive OFC and the severity level of the anaphylactic reaction among all patients who underwent an OFC (OFC‐negative and OFC‐positive patients) . However, as these previous studies evaluated all patients, including challenge‐negative patients, the identified risk factors for anaphylaxis may include the risk factors for a positive OFC.…”

Predictive values of egg‐specific IgE by two commonly used assay systems for the diagnosis of egg allergy in young children: a prospective multicenter study

“…Because of this, it is important that physicians interpreting the results understand the predictive sIgE levels of the particular assay they use. Several studies have reported the predictive sIgE values for a variety of food allergens 7, 8, 9, 10, 11, 12, 13 but mostly using only one assay system: ImmunoCAP ® specific IgE (ImmunoCAP; Phadia, Thermo Fisher Scientific, Inc., Uppsala, Sweden). Similar data are essential for meaningful use of the IMMULITE ® 2000 3gAllergy ™ system (3gAllergy; Siemens Healthcare Diagnostic Inc., Tarrytown, NY, USA), a popular, widely used sIgE assay system with an extended measurement range.…”

“…To avoid unnecessary OFC, the use of 90 or 95% positive decision points has been proposed. These points are based on probability curves determined using quantitative sIgE measurement 7, 12, 13, 15, 16, 17 and may be used in various clinical settings. However, these statistically calculated predictive values can vary significantly among clinics or institutions depending on the assay used and characteristics of the study population, such as age, severity, and prevalence of positive reactions.…”