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Sensitivity and specificity of prick and intradermal testing in predicting response to nasal provocation with timothy
John H Krouse1, Kamran Sadrazodi, Kristy Kerswill
1Department of Otolaryngology, Wayne State University, Detroit, Michiga, USA. jkrouse@med.wayne.edu
Objective:
Examine the efficacy of epicutaneous and intradermal testing in predicting response to nasal provocation with timothy antigen.
Study Design And Setting:
Prospective study. Subjects were tested with Multi-Test II (MT). Subjects with negative wheals were tested with a 1:500 intradermal injection of timothy. They had baseline assessment of nasal cross-sectional area (CSA) using acoustic rhinometry and underwent nasal provocation with increasing timothy concentrations. CSA was assessed and nasal visual analog scale (VAS) completed with each concentration.
Results:
Sensitivity and specificity of MT in predicting nasal response to provocation were 87% and 86%. Intradermal testing increased sensitivity to 93%. Hierarchical linear modeling (HLM) demonstrated that subjects positive to skin testing had significant reductions in CSA and worsening VAS scores with increasing concentrations of nasally delivered antigen.
Conclusion And Significance:
Epicutaneous testing with the Multi-Test II offers 87% sensitivity and 86% specificity in assessing timothy grass reactivity.
