Comparison of the Multi-Test II and ComforTen allergy skin test devices. 2011

Mark S Dykewicz, and Kevin T Dooms, and Deborah L Chassaing
Section of Allergy and Clinical Immunology, Division of Immunobiology, Department of Internal Medicine, Saint Louis University School of Medicine, Missouri, USA. dykewicz@wfubmc.edu

The performance of different devices for percutaneous allergy skin testing may have statistically and clinically significant differences. We compared two multihead allergy skin testing devices: Multi-Test II (Lincoln Diagnostics, Decatur, IL) and ComforTen (Hollister-Stier Laboratories, Spokane, WA). Skin tests with glycerinated histamine (6 mg/mL base) and glycerinated saline were applied to 30 adults using Multi-Test II on the volar surface of one forearm and ComforTen on the opposite forearm. For each device, data were obtained from 150 histamine sites and 90 negative control sites. Defining a positive result using cutoff wheal sizes of either 5-mm versus 3-mm inclusive, respective results for Multi-Test II sensitivity were 97% versus 100% with specificity of 100% versus 97%, whereas corresponding ComforTen sensitivity increased from 26 to 82% with specificity of 100% versus 99%. For Multi-Test II versus ComforTen, histamine mean (SD) wheal sizes were 7.47 (1.72) mm versus 3.93 (1.59) mm (p = 0.00), mean coefficients of variation (CV) were 23.0% versus 40.5%, and pooled estimates of variance were 1.42 versus 1.29. Comparing results at different test head positions, there was no statistically significant variation in histamine wheal sizes with either device. Multi-Test II had notably lower CV, greater wheal size, and higher sensitivity but similar specificity to ComforTen. Consequently, Multi-Test II had superior performance at both 3- and 5-mm wheal cutoffs. Because ComforTen had a low sensitivity at the 3-mm and, particularly, at the 5-mm wheal cutoff, skin testing with this device might result in underdiagnosis of allergy using either cutoff.

UI MeSH Term Description Entries
D006967 Hypersensitivity Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. Allergy,Allergic Reaction,Allergic Reactions,Allergies,Hypersensitivities,Reaction, Allergic,Reactions, Allergic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D003951 Diagnostic Errors Incorrect or incomplete diagnoses following clinical or technical diagnostic procedures. Diagnostic Blind Spots,Errors, Diagnostic,Misdiagnosis,Blind Spot, Diagnostic,Blind Spots, Diagnostic,Diagnostic Blind Spot,Diagnostic Error,Error, Diagnostic,Misdiagnoses
D004864 Equipment and Supplies Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. Apparatus and Instruments,Devices,Medical Devices,Device, Medical,Devices, Medical,Equipment,Inventories,Medical Device,Supplies,Device,Instruments and Apparatus,Inventory,Supplies and Equipment
D005260 Female Females
D006632 Histamine An amine derived by enzymatic decarboxylation of HISTIDINE. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. Ceplene,Histamine Dihydrochloride,Histamine Hydrochloride,Peremin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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