A HEP-index area of 0.4 is determined as cut-off value for a positive SPT. The 'scanned area method' is theoretically more accurate in determining the wheal area than the 'average diameter method' and is recommended in academic research. The four methods showed comparable accuracy in predicting cashew nut reactions in a DBPCFC. The four SPT methods yielded a comparable area under the curve (AUC) of 0.84, 0.85, 0.83 and 0.83, respectively. A wheal average diameter of 3 mm is generally considered as a positive SPT cut-off value and an equivalent HEP-index area cut-off value of 0.4 was calculated. average diameter, area, HEP-index diameter, HEP-index area) were compared in a Receiver-Operating Characteristic (ROC) plot.Ĭharacterizing the wheal size by the average diameter method is inaccurate compared to scanning method. The accuracy in predicting the outcome of the DBPCFC using four different SPT readings (i.e. In addition, the same data for the histamine-induced wheal were collected for each patient. Per patient, the average diameter and scanned area of the wheal size were recorded. All patients underwent a DBPCFC with cashew nut. The objectives of this study are to compare different techniques of quantifying SPT results, to determine a cut-off value for a positive SPT for histamine equivalent prick -index (HEP) area, and to study the accuracy of predicting cashew nut reactions in double-blind placebo-controlled food challenge (DBPCFC) tests with the different SPT methods.ĭata of 172 children with cashew nut sensitisation were used for the analysis. In both methods, skin prick test (SPT) results can be corrected for histamine-sensitivity of the skin by dividing the results of the allergic reaction by the histamine control. A more accurate method is to scan the area of the wheal to calculate the actual size. A commonly used method is to characterize the wheal size by its 'average diameter'. There are several methods to read skin prick test results in type-I allergy testing.
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