PMID- 12911422
OWN - NLM
STAT- MEDLINE
DCOM- 20031224
LR  - 20191210
IS  - 0105-4538 (Print)
IS  - 0105-4538 (Linking)
VI  - 58
IP  - 9
DP  - 2003 Sep
TI  - A further evaluation of the clinical use of specific IgE antibody testing in 
      allergic diseases.
PG  - 921-8
AB  - BACKGROUND: The evaluation and interpretation of the results from blood tests 
      measuring specific immunoglobulin E (IgE) antibody concentration is currently 
      made using the dichotomized result from the test despite a quantitative result is 
      obtained. It has been shown that different levels of IgE antibodies, assessed by 
      blood test and skin prick test, may have a relation to presence of symptoms, 
      implying that there is more information in a quantitative result than in the 
      dichotomous--positive or negative. OBJECTIVE: To investigate the clinical utility 
      of quantification of IgE antibodies in the diagnosis of allergic patients and 
      whether such procedure has any advantage to the presently dichotomously used 
      sensitivity and specificity at a fixed cut-off. METHODS: Data from a previously 
      published study (R. Paganelli, I.J. Ansoteugi, J. Sastre, C.-E. Lange, M.H.W.M. 
      Roovers, H. de Groot, N.B. Lindholm, P.W. Ewan, Allergy, 1998; 53) analysing 
      diagnosis of allergic patients in four different clinics were re-evaluated. In 
      the original study consecutive patients with suspected IgE-mediated allergy had 
      been examined and evaluated according to the clinical routine at each clinic, 
      using case history, physical examination, skin tests and laboratory tests, except 
      the test to be evaluated, and given a "doctors' allergen-specific diagnosis" as 
      positive or negative. In the present study the relation between "doctors' 
      allergen-specific diagnosis", expressed as pos/neg, and the quantitative levels 
      of specific IgE antibody concentration was analysed using a logistic regression 
      model. This presentation of results was also compared with the more common 
      characteristics of sensitivity and specificity, and also with Receiver-operator 
      characteristics (ROC) curves. RESULTS: The used logistic model described the 
      relationship between allergen-specific diagnosis in each study and the levels of 
      IgE antibodies. The shape of the curve illustrated the physicians' disposition 
      for a positive diagnose in the study, in relation to the specific IgE antibody 
      level. Differences in the shape of the curve was found both between allergens 
      within clinics and between clinics for the same allergen. No association could be 
      demonstrated between prevalence and shape of the curve. CONCLUSIONS: Conventional 
      sensitivity/specificity figures or ROC concepts only use the qualitative 
      statement of whether IgE is present or not. A risk assessment using the 
      quantitative level of IgE antibody to an allergen increases the utility of the 
      information in clinical context compared with a qualitative statement of whether 
      IgE is present or not. The quantification demonstrated the link between specific 
      IgE antibodies and allergic reactions. The use of objective, well performing 
      quantitative tests should help improve diagnostic accuracy and might provide a 
      way for the patient to understand and manage his or her daily situation and risk 
      for reactions.
FAU - Soderstrom, L
AU  - Soderstrom L
AD  - Pharmacia Diagnostics AB, SE-751 82 Uppsala, Sweden.
FAU - Kober, A
AU  - Kober A
FAU - Ahlstedt, S
AU  - Ahlstedt S
FAU - de Groot, H
AU  - de Groot H
FAU - Lange, C-E
AU  - Lange CE
FAU - Paganelli, R
AU  - Paganelli R
FAU - Roovers, M H W M
AU  - Roovers MH
FAU - Sastre, J
AU  - Sastre J
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
CIN - Allergy. 2004 Mar;59(3):359-60; author reply 360-1. PMID: 14982523
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Allergens/immunology
MH  - Child
MH  - Humans
MH  - Hypersensitivity/*diagnosis/epidemiology/*immunology
MH  - Immunoglobulin E/*analysis
MH  - Logistic Models
MH  - Middle Aged
MH  - Prevalence
MH  - ROC Curve
MH  - Respiratory Hypersensitivity/diagnosis/immunology
MH  - Risk Assessment
EDAT- 2003/08/13 05:00
MHDA- 2003/12/25 05:00
CRDT- 2003/08/13 05:00
PHST- 2003/08/13 05:00 [pubmed]
PHST- 2003/12/25 05:00 [medline]
PHST- 2003/08/13 05:00 [entrez]
AID - 227 [pii]
AID - 10.1034/j.1398-9995.2003.00227.x [doi]
PST - ppublish
SO  - Allergy. 2003 Sep;58(9):921-8. doi: 10.1034/j.1398-9995.2003.00227.x.