title: Assessment of a qualitative serological assay to screen for allergic sensitization in elderly subjects.
abstract: We used a commercially available specific IgE qualitative serological assay to screen for allergic sensitization. Two hundred twenty-eight elderly subjects took part in the study. Skin-prick tests (SPTs) to a panel of relevant aeroallergens present in the study area were used as the  diagnostic reference procedure (gold standard). Subjects with at least one positive SPT (≥3 mml n = 76) were considered to have developed an allergic sensitization. The qualitative assay correctly classified subjects as sensitized to an allergen or not sensitized in 257 of 288 cases (accuracy,  88.9%; 95% CI, 85.0-92.0%). The qualitative assay sensitivity was 70.0 (95% CI, 58.1-79.7) and specificity was 95.7 (95% CI, 92.1-98.0), positive predictive value (PPV) was 85.4 (95% CI, 85.1-93.4), negative predictive value (NPV) was 89.8 (95% CI, 85.1-93.4),  positive likelihood ratio (LR(+)) was 16.5 (95% CI, 8.7-31.6), negative LR (LR(-)) was 0.31 (95% CI, 0.21-0.43), and the diagnostic odds ratio (DOR) was 52.2 (95% CI, 21.5-133.6). In the elderly subjects with respiratory symptoms, the qualitative  assay correctly classified subjects as allergen sensitized or nonsensitized in 81 of 89 cases (accuracy, 91.0; 95% CI, 85.0-96.9). In this subgroup, the qualitative assay sensitivity was 94.6 (95% CI, 85.1-98.8), specificity was 84.8 (95% CI, 68.1-94.9), PPV was 91.3 (95%  CI, 81.0-97.1), and NPV was 90.3 (95% CI, 74.2-97.9). LR(+) was 6.2 (95% CI, 3.0-14.2), LR(-) was 0.06 (95% CI, 0.02-0.17), and the DOR was 98.9 (95% CI, 18.0-621.4). The qualitative serological assay is a valuable tool for the diagnosis  of allergic sensitization in a population of elderly subjects.
authors: Dipartimento Biomedico di Medicina Interna e Specialistica, Universitàdegli Studi di Palermo, Palermo, Italy. gabriele.dilorenzo@unipa.it
authors: Gabriele
authors: G
authors: Di Lorenzo
authors: Maria Stefania
authors: MS
authors: Leto-Barone
authors: Simona
authors: S
authors: La Piana
authors: Gaia
authors: G
authors: La Porta
authors: Giuseppe
authors: G
authors: Montalto
mesh_terms: D000368:Aged; D000485:Allergens / Q000032:analysis*; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012130:Respiratory Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D012680:Sensitivity and Specificity; D012698:Serologic Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E