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Wise et al.

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Study Year LOE Study design Study groups Clinical endpoint Conclusion Niemeijer et al. 846 1993 2b Cohort Allergy patients (n = 41) Simultaneous SPT, ID testing

Coefficient of variation of ID test histamine wheal size is 6% within patients and 12% between patients. Optimum concentration of tested allergens was 10–100 BU/mL, a 7.5 mm ID wheal is ideal cutoff value for positive result (0.83× the size of average histamine wheal).

Ideal cutoff for positive ID test is wheal diameter 0.7 times the size of histamine control. ID has 83% predictive value vs RAST and 77% predictive value vs clinical history.

Patients with only ID positive skin tests (SPT negative) did not have a positive RAST nor a positive leukocyte histamine release. In contrast, SPT positivity was associated with positive RAST test and leukocyte histamine release assay. When SPT are negative for

perennial rhinitis patients, positive ID tests are not likely to indicate the presence of IgE-mediated allergy.

High degrees of skin reactivity (positive ID tests at high allergen concentrations) correspond with a higher rate of positive clinical history and positive RAST results.

IDT endpoint directly correlates with SPT wheal size for all antigens tested, especially for Bermuda, dust mite, and ragweed.

Peltier & Ryan 850 2006 3b Cohort Volunteers tested simultaneously for mold allergens with SPT and IDT (n = 86) In subjects with clinical symptoms of allergy there was a direct statistically significant correlation between SPT wheal size and IDT endpoint. ID tests identified 10% more positive results compared to SPT alone. Purohit et al. 852 2005 3b Cohort Patients with birch pollen allergy (n = 18) Correlations among IDT endpoint, serum sIgE, and provocation thresholds for basophil histamine release. Schwindt et al. 858 2005 3b Cohort Patients with allergy (n = 97) Using clinical history as gold standard, prick, ID, and challenge test results compared cohort SPT wheal size compared to IDT endpoints

IDT endpoint correlated directly with basophil histamine release in response to allergen exposure. IDT endpoint did not correlate with rBet v 1 serum sIgE level.

If SPT with multi-test II device was negative, 17% of subjects had a positive ID test that corresponded with clinical history. None of these positive ID tests

corresponded with a positive nasal challenge. When multi test II results are negative, positive ID tests are unlikely to identify clinically relevant aeroallergen sensitivity.

A significantly greater number of patient tested positive with IDT compared to SPT. SPT wheal size and IDT endpoint correlated for several allergens. IDT may be more sensitive than SPT.

with varying concentrations of Phleum and D. pteronyssinus , as

Niemeijer et al. 855 1993 2b Cohort Suspected allergy patients (n = 497) Simultaneous ID, pRAST, and clinical history compared. Standardized grass pollen, tree pollen, cat, dust mite tested.

RAST, nasal provocation and leukocyte histamine release

compared to ID positivity, SPT negativity

Positive clinical histories compared to RAST results and IDT results

SPT wheal size compared to IDT endpoint

Allergy clinic patients (n = 34) Patients tested for aeroallergen sensitivity with both IDT and SPT.

well as pRAST on all subjects.

Reddy et al. 857 1978 2b Cohort Patients with perennial rhinitis (n = 34), negative SPT for 60 allergens but with at least 1 positive ID test

Perera et al. 853 1975 2b Cohort Patients referred for allergy diagnostic testing (n = 54)

Peltier & Ryan 844 2007 3b Cohort Volunteers underwent simultaneous SPT and IDT for 5 common allergens (n = 134)

Simons et al. 851 2004 4 Retrospective

AR = allergic rhinitis; BU = biological units; FEV1 = forced expiratory volume in 1 second; ID = intradermal; IDT = intradermal dilutional titration; LOE = level of evidence; pRAST = Phadebas radioallergosorbent test; RAST = radioallergosorbent test; SAR = seasonal allergic rhinitis; sIgE = antigen-specific immunoglobulin E; SPT = skin-prick test.

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