Negative Atopy Patch Test and Negative Skin Prick Test Reduce the Need for Oral Food Challenge in Children with Atopic Dermatitis

Peron, Angela; Tenconi, Rossana; Leone, Marinella; Macellaro, Patrizia; Ceriani, Elena; D'Arcais, Alberto Flores

doi:10.1089/ped.2010.0044

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…A total of 41 eligible studies were included in our meta‐analysis. Firstly, 578 studies were identified by the initial search and supplemented by 7 additional studies which were searched manually.…”

Section: Resultsmentioning

confidence: 99%

“…In the index test domain: (a) high risk of bias: 2 studies; (b) unclear risk of bias: 2 studies; (c) low risk of bias: 37 studies. In the reference standard domain: (a) high risk of bias: 5 studies; (b) unclear risk of bias: 20 studies; (c) low risk of bias: 16 studies. In the flow and timing domain: (a) high risk of bias: 13 studies; (b) unclear risk of bias: 8 studies; (c) low risk of bias: 20 studies.…”

Section: Resultsmentioning

confidence: 99%

“…As for the AUC, it (0.791) indicates that APT is an accurate tool for diagnosing FA regardless of prevalence. Furthermore, with the high sensitivity (but low specificity) of SPT/sIgE, 8 several studies found that the combination of SPT with APT could significantly improve the sensitivity and/or NPV for diagnosing FA, 16,30,31,41,44 while other studies indicated that their combination improved the specificity and/or PPV. 13,21,28,34 It was also reported that APT together with sIgE enhanced the PPV for the diagnosis of FA.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies were judged to be high or unclear risk of bias in all domains except the index test. In the patient selection domain: (a) high risk of bias: 25 studies; 9,14,16,18,22,24,25,[27][28][29][30]32,36,[38][39][40][41][42][43][44][45][46][47]49,51 (b) unclear risk of bias: 10 studies; 7,15,17,19,21,23,26,35,37,50 (c) low risk of bias: 6 studies. 13,20,31,33,34,48 In the index test domain: (a) high risk of bias: 2 studies; 39,46 (b) unclear risk of bias: 2 studies; 23,50 (c) low risk of bias: 37 studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…13,20,31,33,34,48 In the index test domain: (a) high risk of bias: 2 studies; 39,46 (b) unclear risk of bias: 2 studies; 23,50 (c) low risk of bias: 37 studies. In the reference standard domain: (a) high risk of bias: 5 studies; 15,17,21,32,34 (b) unclear risk of bias: 20 studies; 7,14,16,19,[22][23][24][25][27][28][29]35,39,41,43,44,[47][48][49][50] However, the applicability concerns were considered to be low concern in most studies, except 6 studies 16,25,27,32,39,46 to be high concern in the patient selection domain, 3 studies 23,39,50 to be unclear in the index test domain, and 2 studies 27,50 to be unclear in the reference standard domain. Detailed information of QUADAS-2 assessment is represented in Table S2.…”

Section: Quality Assessmentmentioning

confidence: 99%

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The diagnostic value of APT for food allergy in children: a systematic review and meta‐analysis

Luo

Zhang

2019

Pediatric Allergy Immunology

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Background The role of atopy patch test (APT) in the diagnosis of food allergy (FA) remains largely controversial. In our meta‐analysis, we aimed to evaluate the accuracy of APT for diagnosing FA in children. Methods Pubmed, Embase and Cochrane Library were searched for studies regarding the diagnostic value of APT for FA in children compared to oral food challenge (double‐blind placebo‐controlled food challenge and/or open food challenge). The last search was conducted on November 11, 2017. Two reviewers independently screened relevant studies and assessed the quality by QUADAS‐2. Meta‐analysis was performed to calculate the pooled sensitivity, specificity, DOR (diagnostic odds ratio), PLR (positive likelihood ratio), NLR (negative likelihood ratio) with their 95% confidence intervals (CIs). Subgroup analyses were conducted according to different food allergens, atopic dermatitis, gastrointestinal symptoms, and age younger than 3 years. Results Forty‐one studies were included in the meta‐analysis. The pooled sensitivity, specificity, PLR, NLR and DOR were 50.30% (95% CI 48.40%‐52.30%), 86.60% (95% CI 85.30%‐87.80%), 3.405 (95% CI 2.594‐4.470), 0.545 (95% CI 0.469‐0.634) and 7.528 (95% CI 5.507‐11.206), respectively. However, for children with FA‐related gastrointestinal symptoms, the pooled sensitivity and specificity were 57.40% (95% CI 52.10%‐62.50%) and 91.50% (95% CI 88.30%‐94.10%) respectively. Conclusions Our findings suggest that APT is specific but not sensitive for diagnosing FA in children, especially in children with FA‐related gastrointestinal symptoms.

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Section: Resultsmentioning

confidence: 99%