Accuracy of a point-of-care testing device in children with suspected respiratory allergy

Measuring IgE antibodies is useful in the diagnostic workup of allergy and asthma. This study was designed to assess the value of a new point-of-care test (ImmunoCAP Rapid Wheeze-Rhinitis Child [ICR]; Phadia AB, Uppsala, Sweden) in the diagnosis of atopy in children with allergy-like symptoms such as rhinitis, eczema, and recurrent episodes of wheezing. Patients (n = 175; average age, 7.2 years) referred from primary care were consecutively enrolled in two pediatric allergy referral centers in Italy and were assessed during a single visit. The ICR test included egg, milk, house-dust mite, timothy, mugwort, wall pellitory, birch, olive, cat, and dog allergens. ICR results were consistent with 78% of the positive clinical diagnoses. Agreement between negative ICR results and physician's clinical judgment ranged between 92 and 99% for the single allergens and averaged 96% for the complete profile. Overall agreement of ICR versus clinical diagnosis was 93%. A false positive ICR rate of 1% was recorded. ICR was positive for 94% of the patients with at least one positive clinical diagnosis. Based on the agreement between the physician's assessment of the clinical relevance of each allergen and the ICR results, we concluded that ICR could be a useful tool for primary care physicians to rule in or out the clinical relevance of single ICR allergens.