Comparative Evaluation of Four Multiple Allergen Simultaneous Test (MAST) Systems in Clinical Practice

Multiple allergen simultaneous tests (MASTs) are widely used for screening allergen-specific immunoglobulin E owing to their convenience and cost-effectiveness. Recently, several automated MAST analyzers with expanded allergen panels have become available in Korea; however, comparative evaluations remain limited.

In this retrospective study, 200 residual serum samples from patients tested for suspected allergic diseases at a single tertiary hospital were analyzed. Each sample was tested using AdvanSure Alloscreen, AdvanSure Alloscreen Max108, SGTi-Allergy Screen, and PROTIA Allergy-Q. Semi-quantitative results (classes 0-6) were interpreted as positive at class ≥2. Concordance rates and Cohen's kappa coefficients were calculated.

Overall agreement between the MAST systems was high (91-93%), with Cohen's kappa values indicating substantial to almost perfect agreement (κ = 0.67-0.76). The agreement between AdvanSure Alloscreen and its upgraded version, AdvanSure AlloScreen Max108, was the highest. For common allergens in the Korean population, Dermatophagoides pteronyssinus and Dermatophagoides farinae showed moderate agreement (κ = 0.47-0.82, respectively) between the MAST systems. Re-testing of discrepant samples (n = 78; 31 allergens) using ImmunoCAP-often considered the gold standard for allergy testing-demonstrated the highest concordance for the SGTi Allergy Screen (76.39%).

All four MAST systems demonstrated substantial to near-perfect qualitative agreement. The SGTi-Allergy Screen showed the best concordance with ImmunoCAP, whereas AdvanSure Alloscreen Max108 offered a balanced performance with broader allergen coverage. These findings indicate that laboratories should select a MAST system based on local needs, weighing analytical accuracy, allergen panel breadth, and overall testing efficiency.