Performance of specific immunoglobulin E tests for diagnosing occupational asthma a systematic review and meta-analysis
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Performance of specific immunoglobulin E tests for diagnosing occupational asthma a systematic review and meta-analysis. / Lux, Harald; Lenz, Klaus; Budnik, Lygia Therese; Baur, X.
in: OCCUP ENVIRON MED, Jahrgang 76, Nr. 4, 04.2019, S. 269-278.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Performance of specific immunoglobulin E tests for diagnosing occupational asthma a systematic review and meta-analysis
AU - Lux, Harald
AU - Lenz, Klaus
AU - Budnik, Lygia Therese
AU - Baur, X
N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/4
Y1 - 2019/4
N2 - OBJECTIVES: To determine the test performance parameters for the retrievable range of high-molecular-weight (HMW) and low-molecular-weight (LMW) occupational allergens and to evaluate the impact of allergenic components and the implementation of measures for test validation.METHODS: A protocol with predefined objectives and inclusion criteria was the basis of an electronic literature search of MEDLINE and EMBASE (time period 1967-2016). The specific inhalation challenge and serial peak flow measurements were the reference standards for the specific IgE (sIgE) test parameters. All of the review procedures were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS: Seventy-one studies were selected, and 62 entered meta-analysis. Pooled pairs analysis indicated a sensitivity of 0.74(95% CI 0.66 to 0.80) and specificity of 0.71(95% CI 0.63 to 0.77) for HMW allergens and a sensitivity of 0.28(95% CI 0.18 to 0.40) and specificity of 0.89(95% CI 0.77 to 0.95) for LMW allergens. Component-specific analysis improved the test parameters for some allergens. Test validation was handled heterogeneously among studies.CONCLUSION: sIgE test performance is rather satisfactory for a wide range of HMW allergens with the potential for component-specific approaches, whereas sensitivity for LMW allergens is considerably lower, indicating methodological complications and/or divergent pathomechanisms. A common standard for test validation is needed.
AB - OBJECTIVES: To determine the test performance parameters for the retrievable range of high-molecular-weight (HMW) and low-molecular-weight (LMW) occupational allergens and to evaluate the impact of allergenic components and the implementation of measures for test validation.METHODS: A protocol with predefined objectives and inclusion criteria was the basis of an electronic literature search of MEDLINE and EMBASE (time period 1967-2016). The specific inhalation challenge and serial peak flow measurements were the reference standards for the specific IgE (sIgE) test parameters. All of the review procedures were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS: Seventy-one studies were selected, and 62 entered meta-analysis. Pooled pairs analysis indicated a sensitivity of 0.74(95% CI 0.66 to 0.80) and specificity of 0.71(95% CI 0.63 to 0.77) for HMW allergens and a sensitivity of 0.28(95% CI 0.18 to 0.40) and specificity of 0.89(95% CI 0.77 to 0.95) for LMW allergens. Component-specific analysis improved the test parameters for some allergens. Test validation was handled heterogeneously among studies.CONCLUSION: sIgE test performance is rather satisfactory for a wide range of HMW allergens with the potential for component-specific approaches, whereas sensitivity for LMW allergens is considerably lower, indicating methodological complications and/or divergent pathomechanisms. A common standard for test validation is needed.
KW - Journal Article
KW - Review
KW - Area Under Curve
KW - Biomarkers/analysis
KW - Humans
KW - Animals
KW - Asthma, Occupational/blood
KW - Immunoglobulin E/analysis
KW - Cattle
KW - ROC Curve
KW - Allergens/immunology
KW - Edible Grain/immunology
KW - Latex Hypersensitivity/diagnosis
U2 - 10.1136/oemed-2018-105434
DO - 10.1136/oemed-2018-105434
M3 - SCORING: Journal article
C2 - 30804164
VL - 76
SP - 269
EP - 278
JO - OCCUP ENVIRON MED
JF - OCCUP ENVIRON MED
SN - 1351-0711
IS - 4
ER -