Abstract
Skin prick tests are used as a measure of atopy in epidemiological studies, but results may be influenced by the fieldworker performing the test. In a multi-centre epidemiological study the method of reporting the results should consider the need for comparability of findings from different centres. Data on over 1000 subjects from three English centres of the European Community Respiratory Health Survey were analysed to determine whether allergen wheal should be adjusted for histamine wheal, and what cutoff diameter gave the most comparable results. No consistent relation between allergen wheal diameter and histamine wheal diameter was found for any fieldworker or allergen. A cutoff of > 0 mm for a positive result gave a more consistent relation with the corresponding specific IgE value between fieldworkers than either a cutoff of ⩾ 3 mm or the use of the mean wheal diameter. While this result is not immediately generalisable to studies using different skin prick test reagents, the method of analysis to determine the appropriate criterion of reporting can be used in other epidemiological studies.
Similar content being viewed by others
Abbreviations
- ECRHS:
-
European Community Respiratory Health Survey
References
Dreborg S. Skin tests used for epidemiological studies. Allergy 1989; 44 (S10): 52–59.
Omenaas E, Bakke P, Elsayed S, Hanaa R, Gulsvik A. Total and specific serum IgE levels in adults: relationship to sex, age and environmental factors. Clin Exp Allergy 1994; 24: 530–539.
BTTA Report to Research Committee. Immunological features of asthma. Clin Allergy 1975; 5: 403–416.
Clarke CW, Mitchell J, Nunn AJ, Pepys J. Reproducibility of prick skin tests to five common allergens. Clin Allergy 1982; 12: 1–8.
Perrin LF, Dechamp CH, Deviller P, Joly P. Reproducibility of skin tests. Clin Allergy 1984; 14: 581–588.
Ownby DR. Allergy testing: in vivo versus in vitro. Pediatr Clin North Am 1988; 35: 995–1009.
Fadal RG, Nalebuff DJ. RAST: the first twenty years. In: Fadal RG, Nalebuff DJ, eds, Rast in clinical allergy, 2nd ed. Carlsbad, CA: Symposia Foundation, 1989: 355.
Haahtela T, Jokela H. Influence of the pollen season on immediate skin test reactivity to common allergens. Allergy 1980; 35: 15–21.
Osterbale O, Nielsen JP. Allergen-coated lancets (Phazet) for skin prick testing in children. Allergy 1989; 44: 356–362.
BTTA Report to Research Committee. Skin tests and clinical features of asthma. Br J Dis Chest 1975; 69: 125–136.
Basomba A, Sastre A, Pelaez AR, Campos A, Garcia-Villalmanzo A. Standardisation of the prick test. Allergy 1985; 40: 395–399.
Niemeijer NR, Fluks AF, de Monchy JGR Optimization of skin testing, II: Evaluation of concentration and cutoff values, as compared to RAST and clinical history, in a multicenter study. Allergy 1993; 48: 498–503.
Vohlonen I, Terho EO, Koivikko A, Vanto T, Holmen A, Heinonen OP. Reproducibility of the skin prick test. Allergy 1989; 44: 525–531.
Meinert R, Frischer T, Karmaus W, Kuehr J. Influence of skin prick test criteria on estimation of prevalence and incidence of allergic sensitisation in children. Allergy 1994; 49: 526–532.
Haahtela T. Skin tests used for epidemiologic studies. Allergy 1993; 48 (suppl 14): 76–80.
Backman A Editorial. Skin tests for epidemiological studies. Allergy 1994; 49: 493–494.
Demoly P, Bousquet J, Mandersheid J-C, Dreborg S, Dhivert H, Michel F-B. Precision of skin prick and puncture tests with nine methods. J Allergy Clin Immunol 1991; 88: 758–762.
Burney P, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J 1994; 7: 954–960.
Jarvis D, Lai E, Luczynska C, Chinn S, Burney P. The prevalence of astma and asthmalike symptoms in young adults in three East Anglian towns. Br J Gen Pract 1994; 44: 493–497.
Francis B, Green M, Payne C, eds. The GLIM System Release 4 Manual. Oxford: Clarendon Press, 1994.
Cox DR. Note on grouping. J Am Stat Ass 1957; 52: 543–547.
Chinn S. Repeatability and method comparison. Thorax 1991; 46: 454–456.
Landis JR and Koch GG. The measurement of observer agreement for categorical data. Biometrics 1988; 33: 159–174.
Chinn S. Scale, parametric methods and transformations. Thorax 1991; 46: 536–538.
Frew AJ. Skin tests in clinical practice and epidemiology. Clin Exp Allergy 1992; 22: 881–882.
Pepys J. ‘Atopy’: a study in definition. Editorial. Allergy 1994; 49: 397–399.
Burrows B, Sears MR, Flannery EM, Herbison GP, Holdaway MD. Relationships of bronchial responsiveness assessed by methacholine to serum IgE, lung function, symptoms, and diagnoses in 11-year-old New Zealand children. J Allergy Clin Immunol 1992; 90: 376–385.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chinn, S., Jarvis, D., Luczynska, C.M. et al. Measuring atopy in a multi-centre epidemiological study. Eur J Epidemiol 12, 155–162 (1996). https://doi.org/10.1007/BF00145501
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00145501