title: In vivo and in vitro allergy diagnostics: it's time to re-appraise the costs.
abstract: BACKGROUND
  The in vivo skin prick test (SPT) is widely considered less expensive than in vitro gamma-immunoglobulin E (IgE) determination in the diagnosis of allergy. The aim of the present paper is to evaluate the relevance of component-resolved in vitro diagnosis in comparison to extract-based diagnosis and the relative global costs in relation to clinical outcomes.
  
  
  METHODS
  For 50 individuals with suspected seasonal allergic rhinitis, we compared the costs of skin testing with those of specific IgE antibody measurement.
  
  
  RESULTS
  The costs were higher for in vitro than in vivo testing. However, the clinical information obtained using recombinant reagents allowed correct identification of the sensitizing molecule.
  
  
  CONCLUSIONS
  Recombinant allergens for specific IgE in vitro measurement provide more reliable information for immunotherapy prescription. This should be translated into a significant reduction in the overall costs sustained by the healthcare system.
authors: Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.
authors: Franco
authors: F
authors: Borghesan
authors: Daniela
authors: D
authors: Bernardi
authors: Mario
authors: M
authors: Plebani
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens; D001331:Automation; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000191:economics*; D007558:Italy; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012882:Skin Tests / Q000191:economics
chemical_list: D000485:Allergens; D011994:Recombinant Proteins