Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy

Carmen Riggioni; Cristian Ricci; Beatriz Moya; Dominic Wong; Evi van Goor; Irene Bartha; Betul Buyuktiryaki; Mattia Giovannini; Sashini Jayasinghe; Hannah Jaumdally; Andreina Marques-Mejias; Alexandre Piletta-Zanin; Anna Berbenyuk; Margarita Andreeva; Daria Levina; Ekaterina Iakovleva; Graham Roberts; Derek Chu; Rachel Peters; George du Toit; Isabel Skypala; Alexandra F Santos

doi:10.1111/all.15939

Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy

Carmen Riggioni, Cristian Ricci, Beatriz Moya, Dominic Wong, Evi van Goor, Irene Bartha, Betul Buyuktiryaki, Mattia Giovannini, Sashini Jayasinghe, Hannah Jaumdally, Andreina Marques-Mejias, Alexandre Piletta-Zanin, Anna Berbenyuk, Margarita Andreeva, Daria Levina, Ekaterina Iakovleva, Graham Roberts, Derek Chu, Rachel Peters, George du ToitIsabel Skypala, Alexandra F Santos

Department of Ophthalmology, National University of Singapore and National University Health System, Singapore 119228, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117597, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 168751, Singapore; Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore.
London North West University Healthcare NHS Trust
Instituto de Investigación Sanitaria de Navarra
Department of Women and Children's Health
Faculty of Life Sciences and Medicine
Children's Allergy Service and Children's Allergy Service
Koc University School of Medicine
Meyer Children's Hospital IRCCS
Geneva University Hospitals
Department of Neurology, Institute for Postgraduate Education, Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia.
University of Southampton Faculty of Medicine, Southampton University Hospitals NHS Trust, Southampton, United Kingdom.
McMaster Univ, McMaster University, University of Manitoba, Hlth Sci Ctr, Dept Med
University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
Department of Materials, Imperial College London, London SW7 2AZ, United Kingdom; Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom; Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, United Kingdom.
School of Immunology and Microbial Sciences and School of Life Course Sciences
King's College Hospital
PICU Evelina London Children's Hospital
KCL and Guy's and St Thomas' PET Centre, King's College London, King's Health Partners, St. Thomas' Hospital, London, UK.

Research output: Contribution to journal › Review article › peer-review

14 Citations (Scopus)

Abstract

The European Academy of Allergy and Clinical Immunology (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. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 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 combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double-blind placebo-controlled food challenges. 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 (sIgE) to individual components had high specificity: Ara h 2-sIgE had 92%, Cor a 14-sIgE 95%, Ana o 3-sIgE 94%, casein-sIgE 93%, ovomucoid-sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, 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.

Original language	English
Journal	Allergy
DOIs	https://doi.org/10.1111/all.15939
Publication status	E-pub ahead of print - 27 Nov 2023

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10.1111/all.15939

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Riggioni, C., Ricci, C., Moya, B., Wong, D., van Goor, E., Bartha, I., Buyuktiryaki, B., Giovannini, M., Jayasinghe, S., Jaumdally, H., Marques-Mejias, A., Piletta-Zanin, A., Berbenyuk, A., Andreeva, M., Levina, D., Iakovleva, E., Roberts, G., Chu, D., Peters, R., ... Santos, A. F. (2023). Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy. Allergy. Advance online publication. https://doi.org/10.1111/all.15939

@article{d2e9a27910ac45fa929c3dde5bd3be93,

title = "Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy",

abstract = "The European Academy of Allergy and Clinical Immunology (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. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 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 combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double-blind placebo-controlled food challenges. 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 (sIgE) to individual components had high specificity: Ara h 2-sIgE had 92%, Cor a 14-sIgE 95%, Ana o 3-sIgE 94%, casein-sIgE 93%, ovomucoid-sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, 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.",

author = "Carmen Riggioni and Cristian Ricci and Beatriz Moya and Dominic Wong and {van Goor}, Evi and Irene Bartha and Betul Buyuktiryaki and Mattia Giovannini and Sashini Jayasinghe and Hannah Jaumdally and Andreina Marques-Mejias and Alexandre Piletta-Zanin and Anna Berbenyuk and Margarita Andreeva and Daria Levina and Ekaterina Iakovleva and Graham Roberts and Derek Chu and Rachel Peters and {du Toit}, George and Isabel Skypala and Santos, {Alexandra F}",

note = "Funding Information: Carmen Riggioni reports research funding from the Spanish Society of Paediatric Allergy and the National University of Singapore. She is an associate editor for PAI journal and a member of the Paediatric Board for the EAACI. Cristian Ricci, Beatriz Moya, Evi van Goor, Dominic Wong, Irene Bartha, Betul Buyuktiryaki, Mattia Giovannini, Sashini Jayasinghe, Hannah Jaumdally, Andreina Marques‐Mejias, Alexander Piletta‐Zanin, Anna Berbenyuk, Margarita Andreeva, Ekaterina Lakovleva and Derek Chu declare no conflicts of interest. Daria Levina reports a grant from the Moscow Health Department for the standardization of oral food challenges in the Russian Federation. Graham Roberts reports research funding from National Institute of Health and Food Standards Agency. He is president of British Society of Allergy and Clinical Immunology. Rachel Peters reports grants from the National Health & Medical Research Council of Australia. George Du Toit reports grants and personal fees from Aimmune, grants and personal fees from DBV, personal fees from FARE, grants from NIH‐NIAID, grants and personal fees from Novartis, outside the submitted work. Isabel Skypala reports honoraria from ThermoFisher, Royal College of General Practitioners and Touch Independent Medical Education. A.F. Santos reports grants from Medical Research Council (MR/M008517/1; MC/PC/18052; MR/T032081/1), FA Research and Education (FARE), the Immune Tolerance Network/National Institute of Allergy and Infectious Diseases (NIAID, NIH), Asthma UK (AUK‐BC‐2015‐01), BBSRC, Rosetrees Trust and the NIHR through the Biomedical Research Centre (BRC) award to Guy's and St Thomas' NHS Foundation Trust, during the conduct of the study; personal fees from Thermo Scientific, Nutricia, Infomed, Novartis, Allergy Therapeutics, Buhlmann, as well as research support from Buhlmann and Thermo Fisher Scientific through a collaboration agreement with King's College London. AFS is associate editor for Allergy, Clinical and Experimental Allergy and Frontiers in Allergy; and Editorial Board member for the Journal of Allergy and Clinical Immunology and Pediatric Allergy and Immunology. Publisher Copyright: {\textcopyright} 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",

year = "2023",

month = nov,

day = "27",

doi = "10.1111/all.15939",

language = "English",

journal = "Allergy",

issn = "0105-4538",

publisher = "John Wiley and sons",

}

Riggioni, C, Ricci, C, Moya, B, Wong, D, van Goor, E, Bartha, I, Buyuktiryaki, B, Giovannini, M, Jayasinghe, S, Jaumdally, H, Marques-Mejias, A, Piletta-Zanin, A, Berbenyuk, A, Andreeva, M, Levina, D, Iakovleva, E, Roberts, G, Chu, D, Peters, R, du Toit, G, Skypala, I & Santos, AF 2023, 'Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy', Allergy. https://doi.org/10.1111/all.15939

TY - JOUR

T1 - Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy

AU - Riggioni, Carmen

AU - Ricci, Cristian

AU - Moya, Beatriz

AU - Wong, Dominic

AU - van Goor, Evi

AU - Bartha, Irene

AU - Buyuktiryaki, Betul

AU - Giovannini, Mattia

AU - Jayasinghe, Sashini

AU - Jaumdally, Hannah

AU - Marques-Mejias, Andreina

AU - Piletta-Zanin, Alexandre

AU - Berbenyuk, Anna

AU - Andreeva, Margarita

AU - Levina, Daria

AU - Iakovleva, Ekaterina

AU - Roberts, Graham

AU - Chu, Derek

AU - Peters, Rachel

AU - du Toit, George

AU - Skypala, Isabel

AU - Santos, Alexandra F

N1 - Funding Information: Carmen Riggioni reports research funding from the Spanish Society of Paediatric Allergy and the National University of Singapore. She is an associate editor for PAI journal and a member of the Paediatric Board for the EAACI. Cristian Ricci, Beatriz Moya, Evi van Goor, Dominic Wong, Irene Bartha, Betul Buyuktiryaki, Mattia Giovannini, Sashini Jayasinghe, Hannah Jaumdally, Andreina Marques‐Mejias, Alexander Piletta‐Zanin, Anna Berbenyuk, Margarita Andreeva, Ekaterina Lakovleva and Derek Chu declare no conflicts of interest. Daria Levina reports a grant from the Moscow Health Department for the standardization of oral food challenges in the Russian Federation. Graham Roberts reports research funding from National Institute of Health and Food Standards Agency. He is president of British Society of Allergy and Clinical Immunology. Rachel Peters reports grants from the National Health & Medical Research Council of Australia. George Du Toit reports grants and personal fees from Aimmune, grants and personal fees from DBV, personal fees from FARE, grants from NIH‐NIAID, grants and personal fees from Novartis, outside the submitted work. Isabel Skypala reports honoraria from ThermoFisher, Royal College of General Practitioners and Touch Independent Medical Education. A.F. Santos reports grants from Medical Research Council (MR/M008517/1; MC/PC/18052; MR/T032081/1), FA Research and Education (FARE), the Immune Tolerance Network/National Institute of Allergy and Infectious Diseases (NIAID, NIH), Asthma UK (AUK‐BC‐2015‐01), BBSRC, Rosetrees Trust and the NIHR through the Biomedical Research Centre (BRC) award to Guy's and St Thomas' NHS Foundation Trust, during the conduct of the study; personal fees from Thermo Scientific, Nutricia, Infomed, Novartis, Allergy Therapeutics, Buhlmann, as well as research support from Buhlmann and Thermo Fisher Scientific through a collaboration agreement with King's College London. AFS is associate editor for Allergy, Clinical and Experimental Allergy and Frontiers in Allergy; and Editorial Board member for the Journal of Allergy and Clinical Immunology and Pediatric Allergy and Immunology. Publisher Copyright: © 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2023/11/27

Y1 - 2023/11/27

N2 - The European Academy of Allergy and Clinical Immunology (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. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 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 combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double-blind placebo-controlled food challenges. 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 (sIgE) to individual components had high specificity: Ara h 2-sIgE had 92%, Cor a 14-sIgE 95%, Ana o 3-sIgE 94%, casein-sIgE 93%, ovomucoid-sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, 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.

AB - The European Academy of Allergy and Clinical Immunology (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. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 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 combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double-blind placebo-controlled food challenges. 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 (sIgE) to individual components had high specificity: Ara h 2-sIgE had 92%, Cor a 14-sIgE 95%, Ana o 3-sIgE 94%, casein-sIgE 93%, ovomucoid-sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, 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.

UR - http://www.scopus.com/inward/record.url?scp=85178348756&partnerID=8YFLogxK

U2 - 10.1111/all.15939

DO - 10.1111/all.15939

M3 - Review article

C2 - 38009299

SN - 0105-4538

JO - Allergy

JF - Allergy

ER -

Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy

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