title: Allergenius, an expert system for the interpretation of allergen microarray results.
abstract: BACKGROUND
  An in vitro procedure based on a microarray containing many different allergen components has recently been introduced for use in allergy diagnosis. Recombinant and highly purified allergens belonging to different allergenic sources (inhalants, food, latex and hymenoptera) are present in the array. These components can either be genuine or cross-reactive, resistant or susceptible to heat and low pH, and innocuous or potentially dangerous. A large number of complex and heterogeneous relationships among these components has emerged, such that sometimes these interactions cannot be effectively managed by the allergist. In the 1960s, specialized languages and environments were developed to support the replacement of human experts with dedicated decision-making information systems. Currently, expert systems (ES) are advanced informatics tools that are widely used in medicine, engineering, finance and trading.
  
  
  METHODS
  We developed an ES, named Allergenius ®, to support the interpretation of allergy tests based on microarray technology (ImmunoCAP ISAC ®). The ES was implemented using Flex, a LPA Win-Prolog shell. Rules representing the knowledge base (KB) were derived from the literature and specialized databases. The input data included the patient's ID and disease(s), the results of either a skin prick test or specific IgE assays and ISAC results. The output was a medical report.
  
  
  RESULTS
  The ES was first validated using artificial and real life cases and passed all in silico validations. Then, the opinions of allergists with experience in molecular diagnostics were compared with the ES reports. The Allergenius reports included all of the allergists' opinions and considerations, as well as any additional information.
  
  
  CONCLUSIONS
  Allergenius is a trustable ES dedicated to molecular tests for allergy. In the present version, it provides a powerful method to understand ISAC results and to obtain a comprehensive interpretation of the patient's IgE profiling.
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Melioli
authors.affiliation: Logic Programming Associates, Studio 30, Royal Victoria Patriotic Building, Trinity Road, London SW18 3SX, UK.
authors.forename: Clive
authors.initials: C
authors.lastname: Spenser
authors.affiliation: Unità di Biometria, Mediservice S.r.l., Via Matteotti, 43/B - 20864 Agrate Brianza (MI), Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Reggiardo
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Compalati
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Anthi
authors.initials: A
authors.lastname: Rogkakou
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Riccio
authors.affiliation: U.O. Allergologia e Immunologia Clinica, Policlinico, Università di Bari, Piazza Giulio Cesare, 11 - 70124 Bari, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Di Leo
authors.affiliation: U.O. Allergologia e Immunologia Clinica, Policlinico, Università di Bari, Piazza Giulio Cesare, 11 - 70124 Bari, Italy.
authors.forename: Eustachio
authors.initials: E
authors.lastname: Nettis
authors.affiliation: Dipartimento di Medicina Interna, Università di Genova, Largo Rosanna Benzi 10, 16132 Genova, Italy.
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
keywords: 3 TO 10 DIFFERENT ImmunoCAP ISAC; Allergen microarray; Artificial intelligence; Computer supported diagnosis; Cross-reactive component; Expert system; Genuine component; ISAC interpretation