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Medline ® Abstract for Reference 52

of 'Overview of skin testing for allergic disease'

The diagnosis of allergic rhinitis: how to combine the medical history with the results of radioallergosorbent tests and skin prick tests.
Crobach MJ, Hermans J, Kaptein AA, Ridderikhoff J, Petri H, Mulder JD
Scand J Prim Health Care. 1998;16(1):30.
OBJECTIVE: To identify the most useful combinations of symptoms and the results of radioallergosorbent tests (RASTs) and skin prick tests (SPTs) for the diagnosis of allergic rhinitis.
DESIGN: A prospective comparison was made of symptoms and the results of RASTs and SPTs with 7 different nasal allergies; the references used were the "consensus diagnoses" provided by 3 experts.
SETTING: Nineteen general practices in The Netherlands.
PATIENTS: 365 consecutive patients aged 12 or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991.
MAIN OUTCOME MEASURES: The most useful combinations of items from the history, RASTs, and SPTs, for the diagnosis of 7 different nasal allergies; the predictive probabilities of these combinations.
RESULTS: Diagnostic criteria could be drawn up resulting in a near-perfect discrimination between patients diagnosed as having allergic rhinitis and patients diagnosed as not having allergic rhinitis. Most of these criteria combined only a single item from the history with either RAST or SPT. For nearly all nasal allergies, both the negative predictive probabilities and the positive predictive probabilities were 97% or more.
CONCLUSIONS: The common nasal allergies can be diagnosed with a very high certainty with the aid of simple diagnostic criteria. Data from a strictly limited case history combined with either RAST or SPT are sufficient.
Department of General Practice, Leiden University, The Netherlands.