3.4.2 |Studies that include Bos d 4
Evidence for the accuracy of the Bos d 4 diagnostic test comes from
seven studies using two classes of testing equipment[31-33, 35-38]. The AUC of six studies[31-33, 36-38] showed discriminative power ranging
from 0.0 to 3.3, and all studies had estimated specificities above 0.85
(0.88-0.98) regardless of the cutoff value used. Sensitivity was
variable, ranging between 0.50 and 0.82. However, another study had low
sensitivity and specificity[35] which were 0.56
and 0.78, respectively.
In the study by Alessandri[31], both devices were
used to detect Bos d 4 accurately with essentially the same sensitivity
and specificity. Using a cut-off point of 0 (kUa/L) (ISAC standard
unit), the sensitivity and specificity were 0.56 and 0.88, respectively.
When a cut-off value of 1.02 (kUa/L) (ImmunoCAP normalized unit) was
employed, the sensitivity and specificity were 0.58 and 0.81,
respectively. In Nieminen’s study[36], children
aged 1 ~ 2 years had smaller AUC and higher sensitivity
in this group compared to children aged 3-14 years. Their sensitivity
and specificity were 0.51 and 0.94, 0.32 and 0.93, respectively.