Graphical Abstract
Clinical utility of Th2-related markers for local allergic rhinitis: a meta-analysis and indirect comparison of diagnostic test accuracy
Volume: 0 - Issue: 0
First page: 0 - Last page: 0
M.P. Hoang - K. Seresirikachorn - W. Chitsuthipakorn - K. Snidvongs
DOI: 10.4193/Rhin25.237
BACKGROUND: The role of Th2-related biomarkers as a diagnostic tool for local allergic rhinitis (LAR) remains controversial. This study seeks to assess the clinical utility of these markers and rank their diagnostic accuracy for LAR. METHODS: Systematic searches were conducted across five electronic databases. Pooled outcomes, including sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR), were calculated. Relative diagnostic outcomes with a 95% confidence interval between index tests were computed using the indirect comparison of modalities. RESULTS: Twenty-one studies met the inclusion criteria, assessing the diagnostic accuracy of three index tests compared to nasal provocation test for LAR. Among the three biomarkers, sensitivities ranged from 48.1% to 69.1%, with nasal eosinophilia (nEos) showing the highest sensitivity but lowest specificity (56.2%). Nasal-specific IgE (nsIgE) demonstrated perfect specificity (100%) but limited sensitivity (48.1%), the highest DOR (significant), and the highest LR+ (not significant). Basophil activation test (BAT) had the lowest LR- with statistical significance. Indirect comparisons showed BAT and nsIgE had significantly higher sensitivities than nEos. CONCLUSIONS: Nasal-specific IgE and the basophil activation test can help diagnose local allergic rhinitis, but their sensitivities are low. Negative results should be confirmed with a nasal provocation test. Heterogeneity in reported sensitivities further underscores the limitations of current diagnostic methods.
Rhinology 0-0: 0-0, 0000
