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The predictive value of the skin prick test weal size for the outcome of oral food challenges.
Clin Exp Allergy 2005; 35(9):1220-6CE

Abstract

BACKGROUND

The skin prick test (SPT) is regarded as an important diagnostic measure in the diagnostic work-up of food allergy. Objective To evaluate the diagnostic capacity of the SPT in predicting the outcome of oral food challenges, and to determine decision points for the weal size and the skin index (SI) that could render double-blind, placebo-controlled food challenges unnecessary.

METHODS

In 385 children (median age 22 months), 735 controlled oral challenges were performed with cow's milk (CM), hen's egg (HE), wheat and soy. Three hundred and thirty-six of 385 (87%) children suffered from atopic dermatitis. SPT was performed in all children. Diagnostic capacity, receiver-operator characteristics (ROC) curves and predictive decision points were calculated for the mean weal size and the calculated SI.

RESULTS

Three hundred and twelve of 735 (43%) oral food challenges were assessed to be positive. Calculation of 95% and 99% predicted probabilities using logistic regression revealed predictive decision points of 13.0 and 17.8 mm for HE, and 12.5 and 17.3 mm for CM, respectively. However, using the SI, the corresponding cut-off levels were 2.6 and 3.7, respectively, for HE, and 2.7 and 3.7 for CM. For wheat, 95% and 99% decision points of 2.2 and 3.0 were found in children below 1 year of age.

CONCLUSION

Predictive decision points for a positive outcome of food challenges can be calculated for HE and CM using weal size and SI. They may help to avoid oral food challenges.

Authors+Show Affiliations

Department of Pediatric Pneumology and Immunology, University Children's Hospital Charité of Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany.

Pub Type(s)

Evaluation Studies
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16164451

Citation

Verstege, A, et al. "The Predictive Value of the Skin Prick Test Weal Size for the Outcome of Oral Food Challenges." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 35, no. 9, 2005, pp. 1220-6.
Verstege A, Mehl A, Rolinck-Werninghaus C, et al. The predictive value of the skin prick test weal size for the outcome of oral food challenges. Clin Exp Allergy. 2005;35(9):1220-6.
Verstege, A., Mehl, A., Rolinck-Werninghaus, C., Staden, U., Nocon, M., Beyer, K., & Niggemann, B. (2005). The predictive value of the skin prick test weal size for the outcome of oral food challenges. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 35(9), pp. 1220-6.
Verstege A, et al. The Predictive Value of the Skin Prick Test Weal Size for the Outcome of Oral Food Challenges. Clin Exp Allergy. 2005;35(9):1220-6. PubMed PMID: 16164451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The predictive value of the skin prick test weal size for the outcome of oral food challenges. AU - Verstege,A, AU - Mehl,A, AU - Rolinck-Werninghaus,C, AU - Staden,U, AU - Nocon,M, AU - Beyer,K, AU - Niggemann,B, PY - 2005/9/17/pubmed PY - 2006/1/18/medline PY - 2005/9/17/entrez SP - 1220 EP - 6 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 35 IS - 9 N2 - BACKGROUND: The skin prick test (SPT) is regarded as an important diagnostic measure in the diagnostic work-up of food allergy. Objective To evaluate the diagnostic capacity of the SPT in predicting the outcome of oral food challenges, and to determine decision points for the weal size and the skin index (SI) that could render double-blind, placebo-controlled food challenges unnecessary. METHODS: In 385 children (median age 22 months), 735 controlled oral challenges were performed with cow's milk (CM), hen's egg (HE), wheat and soy. Three hundred and thirty-six of 385 (87%) children suffered from atopic dermatitis. SPT was performed in all children. Diagnostic capacity, receiver-operator characteristics (ROC) curves and predictive decision points were calculated for the mean weal size and the calculated SI. RESULTS: Three hundred and twelve of 735 (43%) oral food challenges were assessed to be positive. Calculation of 95% and 99% predicted probabilities using logistic regression revealed predictive decision points of 13.0 and 17.8 mm for HE, and 12.5 and 17.3 mm for CM, respectively. However, using the SI, the corresponding cut-off levels were 2.6 and 3.7, respectively, for HE, and 2.7 and 3.7 for CM. For wheat, 95% and 99% decision points of 2.2 and 3.0 were found in children below 1 year of age. CONCLUSION: Predictive decision points for a positive outcome of food challenges can be calculated for HE and CM using weal size and SI. They may help to avoid oral food challenges. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/16164451/The_predictive_value_of_the_skin_prick_test_weal_size_for_the_outcome_of_oral_food_challenges_ L2 - https://doi.org/10.1111/j.1365-2222.2005.2324.x DB - PRIME DP - Unbound Medicine ER -