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Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy
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  • CARMEN RIGGIONI,
  • Cristian Ricci,
  • Beatriz Moya,
  • Dominic Wong,
  • Evi van Goor,
  • I Bartha,
  • Betul Buyuktiryaki,
  • Mattia Giovannini,
  • Sashini Jayasinghe,
  • Hannah Jaumdally,
  • Andreina Marques-Mejias,
  • Alexandre Piletta-Zanin,
  • Anna Berbenyuk,
  • Margarita Andreeva,
  • Daria Levina ,
  • Ekaterina Spiridonova,
  • Graham Roberts,
  • Derek Chu,
  • Rachel Peters,
  • George Du Toit,
  • Isabel Skypala,
  • Alexandra Santos
CARMEN RIGGIONI
National University of Singapore Yong Loo Lin School of Medicine
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Cristian Ricci
North-West University
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Beatriz Moya
Hospital Universitario 12 de Octubre
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Dominic Wong
University College London School of Life and Medical Sciences
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Evi van Goor
University College London School of Life and Medical Sciences
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I Bartha
University College London School of Life and Medical Sciences
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Betul Buyuktiryaki
Koc University School of Medicine
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Mattia Giovannini
Meyer Children's Hospital IRCCS
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Sashini Jayasinghe
University College London School of Life and Medical Sciences
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Hannah Jaumdally
University College London School of Life and Medical Sciences
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Andreina Marques-Mejias
University College London School of Life and Medical Sciences
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Alexandre Piletta-Zanin
Hopitaux Universitaires Geneve Maternite
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Anna Berbenyuk
Institute of Child's Health Sechenov First Moscow State Medical University (Sechenov University
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Margarita Andreeva
Institute of Child's Health Sechenov First Moscow State Medical University (Sechenov University
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Daria Levina
Institute of Child's Health Sechenov First Moscow State Medical University (Sechenov University
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Ekaterina Spiridonova
Institute of Child's Health Sechenov First Moscow State Medical University (Sechenov University
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Graham Roberts
University of Southampton Faculty of Medicine
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Derek Chu
McMaster University Department of Medicine
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Rachel Peters
Murdoch Children's Research Institute
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George Du Toit
University College London School of Life and Medical Sciences
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Isabel Skypala
Imperial College London National Heart and Lung Institute
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Alexandra Santos
University College London School of Life and Medical Sciences

Corresponding Author:[email protected]

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Abstract

Abstract: Background: The European Academy of Allergy and Clinical Immunology’s (EAACI) is updating the Guidelines on Food Allergy Diagnosis. We aimed to undertake a systematic review of the literature with meta-analyses to assess the accuracy of diagnostic tests for IgE-mediated food allergy. Methods: We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 st October 2012 and 30 th June 2021 according to a previously published protocol (CRD42021259186). We independently screened abstracts, extracted data from full-texts, and assessed risk of bias with QUADRAS 2 tool in duplicate. Meta analyses were undertaken for food-test combination where 3 or more studies were available. Results: 149 studies comprising 24,489 patients met the inclusion criteria and were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% undertaken in Europe, ≥95% conducted in a specialized pediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% DBPCFC. Skin prick test (SPT) with fresh cow’s milk and raw egg had high sensitivity (90% and 94%) for milk and cooked egg allergies. Specific IgE to individual components had high specificity: Ara h 2 had 92%, Cor a 14 95%, Ana o 3 94%, casein 93%, ovomucoid 92/91% for the diagnosis of peanut, hazelnut, cashew, cow’s milk and raw/cooked egg allergies, respectively. BAT was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. Conclusions: SPT and specific IgE to extracts had high sensitivity whereas specific IgE to components and BAT had high specificity to support the diagnosis of individual food allergies. PROSPERO registration: CRD42021259186 Funding: European Academy of Allergy (EAACI).
11 Jul 2023Submitted to Allergy
12 Jul 2023Submission Checks Completed
12 Jul 2023Assigned to Editor
12 Jul 2023Review(s) Completed, Editorial Evaluation Pending
16 Jul 2023Reviewer(s) Assigned
08 Aug 2023Editorial Decision: Revise Minor
27 Sep 20231st Revision Received
27 Sep 2023Submission Checks Completed
27 Sep 2023Assigned to Editor
27 Sep 2023Review(s) Completed, Editorial Evaluation Pending
28 Sep 2023Reviewer(s) Assigned
20 Oct 20232nd Revision Received
20 Oct 2023Submission Checks Completed
20 Oct 2023Assigned to Editor
20 Oct 2023Review(s) Completed, Editorial Evaluation Pending
24 Oct 2023Editorial Decision: Accept