Comparison of intradermal dilutional testing, skin prick testing, and modified quantitative testing for common allergens

Objectives: To compare and correlate wheal size using the Multi-Test II applicator with the endpoint obtained by intradermal dilutional testing (IDT) for 5 common allergens. To examine the safety of modified quantitative testing (MQT) for determining immunotherapy starting doses. Study design: Prospective comparative clinical study. Subjects and methods: A total of 134 subjects were simultaneously skin tested for immediate hypersensitivity using the Multi-Test II device and IDT. Results: There was a 77% concordance between results from IDT and results from MQT. When there was a difference, MQT predicted a safer endpoint for starting immunotherapy in all but 2 cases. Conclusion: Wheal size by SPT is predictive of endpoint by IDT. MQT is nearly as effective as formal IDT in determining endpoint. Significance: Modified quantitative testing appears to be a safe alternative to IDT for determining starting doses for immunotherapy. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.