title: Questionnaire predictors of atopy in a US population sample: findings from the National Health and Nutrition Examination Survey, 2005-2006.
abstract: Allergic conditions and biochemical measures are both used to characterize atopy. To assess questionnaires' ability to predict biochemical measures of atopy, the authors used data on 5 allergic conditions (allergy, hay fever, eczema, rhinitis, and itchy rash) and serum-specific immunoglobulin E (IgE) levels from the 2005-2006 National Health and Nutrition Examination Survey. Atopy was defined as 1 or more positive specific IgEs (≥0.35 kU/L). Questionnaire responses were assessed for sensitivity, specificity, and positive and negative predictive values for atopy. In this population-based US sample, 44% of participants were specific IgE-positive and 53% reported at least 1 allergic condition. Discordance between atopy and allergic conditions was considerable; 37% of persons with atopy reported no allergic condition, and 48% of persons who reported an allergic condition were not atopic. Thus, no combination of self-reported allergic conditions achieved both high sensitivity and high specificity for IgE. The positive predictive value of reported allergic conditions for atopy ranged from 50% for eczema to 72% for hay fever, while the negative predictive value ranged from 57% for eczema to 65% for any condition. Given the high proportion of asymptomatic participants who were specific IgE-positive and persons who reported allergic conditions but were specific IgE-negative, it is unlikely that questionnaires will ever capture the same participants as those found to be atopic by biochemical measures.
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709-2233, USA. hoppin1@niehs.nih.gov
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Renee
authors.initials: R
authors.lastname: Jaramillo
authors.forename: Paivi
authors.initials: P
authors.lastname: Salo
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: London
authors.forename: Darryl C
authors.initials: DC
authors.lastname: Zeldin
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004485:Eczema / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D007073:Immunoglobulin E / Q000097:blood*; D007155:Immunologic Factors / Q000097:blood*; D007223:Infant; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D007155:Immunologic Factors; D007073:Immunoglobulin E