BACKGROUND: The clinical diagnosis is often subjective and susceptible to bias, yet it is the primary standard by which diagnostic tests are judged. Consequently, our opinions regarding various diagnostic tests may not be entirely accurate. OBJECTIVE: To investigate the accuracy of the clinical history compared with concordant skin and quantitative specific IgE (s-IgE) measurements. METHODS: Consecutive, consenting @entity1 (N = 152) at 2 different @entity566 centers were examined by @entity4270 ( @entity4270 ) alone to determine their sensitivity to 7 common allergens. Results were classified as positive, negative, or indeterminate. The @entity4270 results were then compared to concordant skin prick testing (SPT) and s-IgE measurements and to quantitative IgE antibody measurements with and without knowledge of the SPT results. RESULTS: Diagnosis by @entity4270 deviated considerably from concordant SPT and s-IgE results. This deviation differed between allergists and allergens, reflecting a positive @entity4270 bias that averaged 22%. Seventy-six percent of the @entity4270 results judged indeterminate were resolved as negative. Using additional information from the quantification of s-IgE antibodies, considerable differences between the sites in the level of s-IgE associated with a positive @entity4270 result with and without SPT results were observed. CONCLUSIONS: Relative to the SPT and quantification of s-IgE antibodies, the diagnosis by @entity4270 alone to common allergens is not consistent. Discrepancies were dependent on both allergen and allergist. The quantitative s-IgE data revealed that allergists use available information from the @entity4270 and SPT differently. Since the @entity4270 is the primary standard used in judging test efficacy (sensitivity and specificity), our current impressions of test performances are not likely to be accurate.

Are our impressions of XXXX test performances correct?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity566 :: ('MESH:D006967', 'Disease') :: ['allergy'] @entity4270 :: ('MESH:D059445', 'Disease') :: ['history and physical examination', 'HPE']
@entity566 :: (MESH:D006967,Disease) :: ['allergy']
