TY - JOUR
T1 - Comparison of the sensitivity and precision of four skin test devices
AU - Engler, David B.
AU - DeJarnatt, Alan C.
AU - Sim, Tommy C.
AU - Lee, Jana L.
AU - Grant, J. Andrew
N1 - Funding Information:
From the Division of Allergy and Immunology, Department Internal Medicine, The University of Texas Medical Branch Galveston. Supported by a grant from Greer Laboratories, Received for publication May 23, 1991. Revised Jan. 2. 1992. Accepted for publication Feb. 7, 1992. Reprint requests: David B. Engler, MD, The Allergy Clinic, Fannin, Suite 100, Houston. TX 77054-1918.
PY - 1992/12
Y1 - 1992/12
N2 - Twenty volunteers were skin tested with seven concentrations of histamine phosphate and a glycerosaline control to determine the relative sensitivity and precision of four skin test devices Greer Pen (GP), Greer DermaPIK (DP), Center Multi-Test (MT), and Morrow Brown needle (MB). The end points of the study were (1) wheal and flare response of each device, with a dose-response curve, (2) the time required to apply each set of eight tests, and (3) the volunteers' subjective assessment of each device. On a different day, 10 of the volunteers were tested to determine the precision of each device. Dose-response curves for half-log dilutions of histamine phosphate were produced with a glycerosaline control. The DP and GP induced wheal and flare responses discernible from that of the glycerosaline control at a lower concentration of histamine phosphate than the MB and MT. The DP took a shorter time to apply eight samples than any other device. The MB was preferred by the most volunteers, but any device tested on the upper half of the back was usually preferred over that tested on the lower half. When 5 mg ml histamine phosphate was used, coefficients of variation for each device demonstrated that for wheals the precision of the DP, GP, and MT was similar (mean, 21.1%, 23.1%, and 24.5%, respectively). The MB was larger (mean, 59.9%). For flares, the precision of GP and DP was similar (mean, 22.0% and 23.5%, respectively), with the MT and MB larger (mean, 35.5% and 58.@%, respectively). Repeating the analysis for the MB with 10 mg ml histamine phosphate, we found a mean coefficient of variation of 16.5% for wheals and 19.6% for flares. We conclude that the DP is equal to the GP in precision and sensitivity for wheal and flare, but it has the advantage of allowing allergy skin testing to be performed more quickly. The MT has similar precision for wheals but has less precision for flares. The MB device is more precise only with higher concentrations of histamine phosphate than those routinely used in the clinical practice of allergy.
AB - Twenty volunteers were skin tested with seven concentrations of histamine phosphate and a glycerosaline control to determine the relative sensitivity and precision of four skin test devices Greer Pen (GP), Greer DermaPIK (DP), Center Multi-Test (MT), and Morrow Brown needle (MB). The end points of the study were (1) wheal and flare response of each device, with a dose-response curve, (2) the time required to apply each set of eight tests, and (3) the volunteers' subjective assessment of each device. On a different day, 10 of the volunteers were tested to determine the precision of each device. Dose-response curves for half-log dilutions of histamine phosphate were produced with a glycerosaline control. The DP and GP induced wheal and flare responses discernible from that of the glycerosaline control at a lower concentration of histamine phosphate than the MB and MT. The DP took a shorter time to apply eight samples than any other device. The MB was preferred by the most volunteers, but any device tested on the upper half of the back was usually preferred over that tested on the lower half. When 5 mg ml histamine phosphate was used, coefficients of variation for each device demonstrated that for wheals the precision of the DP, GP, and MT was similar (mean, 21.1%, 23.1%, and 24.5%, respectively). The MB was larger (mean, 59.9%). For flares, the precision of GP and DP was similar (mean, 22.0% and 23.5%, respectively), with the MT and MB larger (mean, 35.5% and 58.@%, respectively). Repeating the analysis for the MB with 10 mg ml histamine phosphate, we found a mean coefficient of variation of 16.5% for wheals and 19.6% for flares. We conclude that the DP is equal to the GP in precision and sensitivity for wheal and flare, but it has the advantage of allowing allergy skin testing to be performed more quickly. The MT has similar precision for wheals but has less precision for flares. The MB device is more precise only with higher concentrations of histamine phosphate than those routinely used in the clinical practice of allergy.
KW - Skin testing
KW - allergy testing
KW - histamine
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U2 - 10.1016/0091-6749(92)90472-E
DO - 10.1016/0091-6749(92)90472-E
M3 - Article
C2 - 1460202
AN - SCOPUS:0027092357
SN - 0091-6749
VL - 90
SP - 985
EP - 991
JO - The Journal of Allergy and Clinical Immunology
JF - The Journal of Allergy and Clinical Immunology
IS - 6 PART 1
ER -