Variability in Skin Prick Test Results Performed by Multiple Operators Depends on the Device Used 英文参考文献.docVIP

ORIGINALSTUDY VariabilityinSkinPrickTestResultsPerformedbyMultiple OperatorsDependsontheDeviceUsed RebeccaL.Werther,MBBS,FRACP,1SharonChoo,MBBS,FRACP,FRCPA,1KatherineJ.Lee,BSc,PhD,2,3 DebraPoole,BNurs,1KatrinaJ.Allen,MBBS,BMedSc,FRACP,PhD,1,2,3 andMimiL.K.Tang,MBBS,PhD,FRACP,FRCPA1,2,3 E–mediated allergy.1 Although the doctor-supervised oral Background:Thevariabilityofskinpricktestresultswhencarried foodchallengeisthegoldstandardforthediagnosisoffood allergy,adetailedmedicalhistorytogetherwithSPTcanhelp out by multiple users has not previously been assessed across different devices or between different sites on the body. Such todeterminethelikelihoodthatoneisallergictoafoodand multiuservariabilityhasimportantimplicationsforclinicalpractice. Objectives: We assessed the variability of measurements from 4 commonly used single-headed skin test devices when used by multiple operators and examined whether the variability in perfor- mancewasdifferentonthebackcomparedwiththeforearm. Methods:Eightadultvolunteer“operators”weretrainedintheuse of4devices:GreerPick,Quintip,StallergenesLancet,andFeather Lancet.Eachoperatorperformedahistamineskinpricktestwithall devicesonthebacksandforearmsof5volunteer“receivers.”Var- iability in results was assessed using a multilevel (random effects) regressionmodel. Results:Aftercontrollingforvariationbetweenusersandreceivers, the residual variability or “measurement error” was least for the StallergenesLancet,closelyfollowedbytheQuintip.TheGreerPick hadthegreatestvariability.Therewasgreatervariabilityinmeasure- mentsonthearmcomparedwiththeback. 2,3 subsequently guide further management. Furthermore, serial SPT over time is often used to monitor for resolution offoodallergy,providingclinicaldecisionpointsforwhenan oral food challenge may be of assistance in assessing for acquisition of tolerance. It is therefore important that SPT can offer reproducible results with high precision and accu- racy. In busy clinical practices and large populati