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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE VIII.E.2.

Evidence for the role of intradermal skin testing in the diagnosis of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Nevis et al. 830 2016 1a Systematic review AR patients who underwent skin testing (n = 430) Sensitivity and specificity of skin testing methods ID testing had higher sensitivity and specificity when used as a stand-alone test than when used to confirm SPT. Larrabee et al. 859 2015 2b Cohort AR patients who underwent ID testing based on high suspicion after negative SPT (n = 87) Result of ID test 21% were ID positive, more likely for indoor allergens. Gungor et al. 833 2004 2b Cohort Patients with SAR and ragweed sensitivity (n = 62) Nasal provocation testing, rhinomanometry Sensitivity and specificity of ID testing was comparable to SPT. Krouse et al. 832 2004 2b Cohort SAR (n = 37): 1 Positive SPT; 2 Negative SPT, positive ID test; 3 Negative SPT, negative ID test Nasal provocation with Timothy grass, rhinomanometry ID testing after SPT increased the sensitivity from 87% to 93%. Krouse et al. 831 2004 2b Cohort AR (n = 44): 1 Positive SPT; 2 Negative SPT, positive ID test; 3 Negative SPT, negative ID test Nasal allergen provocation score for Alternaria , visual analog scale, rhinomanometry

ID testing after SPT increased the sensitivity from 42% to 58%.

ID scores added little value beyond SPT and RAST values.

Positive ID along with negative SPT did not indicate the presence of clinically significant sensitivity.

For rhinitis patients, SPT, ID, and conjunctival challenge were more sensitive than serum sIgE. All testing methods had similar specificity.

Cat exposure challenge, symptom scores, FEV1

Nasal challenge with Timothy grass

SPT, ID, challenge tests and in vitro sIgE. Clinical history and nasal/bronchial challenge considered gold standard.

1 SAR, negative SPT, positive ID test; 2 SAR, positive SPT;

3 SAR, positive SPT, positive ID test; 4 No rhinitis

Escudero et al. 860 1993 2b Cohort Rhinitis patients (n = 66), 31 with Alternaria allergy

Wood et al. 793 1999 2b Cohort Patients with a history of symptoms with cat exposure (n = 120) Nelson et al. 856 1996 2b Cohort (n = 70):

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.