Open Access Online Calculator Predicts Peanut-Allergic Reactions With High Accuracy

Abstract

Background: The Peanut Allergy Prediction Web Tool is a newly developed online aid, which calculates the probability of an individual's allergic reaction based on their skin prick test (SPT), Arachis hypogaea 2-specific IgE (Ara h 2-sIgE), and/or basophil activation test (BAT) results.

Objective: To validate the diagnostic performance of the online tool and assess its ability to discriminate between peanut-allergic (PA) and peanut-sensitized tolerant (PST) cases.

Methods: Demographic data, clinical history, results for SPT, Ara h 2-sIgE, BAT, and oral food challenge (OFC) outcomes were collected for pediatric cases with a confirmed peanut allergy status (PA or PST). Receiver operating characteristic curve analysis, area under the curve (AUC), and sensitivity (S), specificity (Sp) positive and negative predictive values (PPV and NPV) were determined to assess the diagnostic performance of the tool using variations of 1, 2, or 3 test results.

Results: The AUC value for all test result combinations exhibited excellent degrees of discriminative performance between PA and PST individuals. The BAT was the greatest single test performer (AUC = 0.945, S = 85%, Sp = 97%, PPV = 99%, and NPV = 71%). The 2-test combination of Ara h 2-sIgE and BAT (AUC = 0.959, S = 87%, Sp = 97%, PPV = 99%, and NPV = 74%) and the 3-test combination (AUC = 0.949, S = 88%, Sp = 89%, PPV = 96%, and NPV = 74%) demonstrated the highest discriminatory ability and diagnostic accuracy.

Conclusion: The Peanut Allergy Prediction Web Tool's diagnostic performance proves highly accurate using several different combinations of test results when classifying PA and PST cases. Future validation is needed to assess the tool's performance in predicting PA severity in comparison with OFC outcomes.

Keywords: Ara h 2; Basophil activation test; Diagnosis; Food allergy; IgE; Oral food challenge; Peanut allergy; Severity; Skin prick test; Validation.