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

Area of Science:

• * Clinical immunology and allergy diagnostics.
• * Development and validation of in vitro diagnostic assays.

Background:

• * Multiple allergen simultaneous tests (MASTs) are convenient and cost-effective for screening allergen-specific immunoglobulin E.
• * New automated MAST analyzers with expanded allergen panels are available in Korea, but comparative data are limited.

Purpose of the Study:

• * To evaluate and compare the performance of four automated MAST systems available in Korea.
• * To assess the concordance between different MAST platforms and with ImmunoCAP, a reference standard.

Main Methods:

• * Retrospective analysis of 200 residual serum samples from patients with suspected allergic diseases.
• * Testing performed on AdvanSure Alloscreen, AdvanSure Alloscreen Max108, SGTi-Allergy Screen, and PROTIA Allergy-Q.
• * Concordance rates and Cohen's kappa coefficients calculated; discrepant samples re-tested with ImmunoCAP.

Main Results:

• * High overall agreement (91-93%) and substantial to almost perfect agreement (κ = 0.67-0.76) among the four MAST systems.
• * SGTi-Allergy Screen demonstrated the highest concordance (76.39%) with ImmunoCAP for discrepant samples.
• * AdvanSure Alloscreen Max108 showed the highest agreement with its predecessor, AdvanSure Alloscreen.

Conclusions:

• * All evaluated MAST systems exhibit substantial to near-perfect qualitative agreement.
• * SGTi-Allergy Screen offers superior concordance with the gold standard ImmunoCAP.
• * AdvanSure Alloscreen Max108 provides a balance of performance and allergen coverage, suggesting selection should align with laboratory needs.