A Comparison of Skin Endpoint Titration and Skin-Prick Testing in the Diagnosis of Allergic Rhinitis

Abstract

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

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“…If ID testing is negative after a negative SPT, it is concluded that the patient is unlikely to be sensitive to that allergen . However, if ID testing is positive after a negative SPT, it is possible that this indicates clinically relevant allergy …”

Use of Intradermal Dilutional Testing and Skin Prick Testing: Clinical Relevance and Cost Efficiency

“…A recent study showed that IDT compared favorably with both SPT and nasal provocation testing (NPT). In fact, there was no statistically significant difference in the positive or negative predictive value between IDT and SPT 37 . This paper is especially significant because it uses a third technique, NPT, as a means to compare IDT and SPT.…”

“…In fact, there was no statistically significant difference in the positive or negative predictive value between IDT and SPT. 37 This paper is especially significant because it uses a third technique, NPT, as a means to compare IDT and SPT. One of the limitations of this study was the sample size (n ϭ 62), but the study was powered to be able to show equivalency between the testing techniques.…”

Ragweed-induced allergic rhinoconjunctivitis: current and emerging treatment options

“…Diagnostic approaches in ragweed-induced allergic rhinitis include obtaining the patient’s precise medical history, especially in terms of potential sources of exposure, seasonal symptoms of nasal inflammation, and relevant comorbidities like asthma. Following this, a skin prick test 38 and nasal provocation are the main clinical tests applied today. In vitro testing allows for the subclassification of allergens and cross-reactions.…”