International Rhinologic Society Rhinology 0300-0729 2026 06 04 Impact of real-world confounders on the accuracy of an AI model to support read out of skin prick automated test results EN K. Roux Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, Leuven, Belgium A.M. Chaker Department of Otorhinolaryngology and Center of Allergy and Environment (ZAUM), TUM School of Medicine and Health, TUM University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany P.W. HellingsAffiliation1 Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, Leuven, Belgium. Affiliation2 Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology G. De Greve Department of Otorhinolaryngology-Head and Neck Surgery, ZAS Sint-Augustinus, Antwerp, Belgium V. Hox Service d'Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium A.L. Poirrier ENT Department, CHU Liège, Liège, Belgium R. DaemsAffiliation1 Hippo Dx, Aarschot, Belgium Affiliation 2 IDLab, Ghent University-imec, Ghent, Belgium D. Loeckx Hippo Dx, Aarschot, Belgium S. GorrisAffiliation1 Hippo Dx, Aarschot, Belgium. Affiliation2 Department of Otorhinolaryngology, AZ Herentals, Herentals, Belgium L. van GervenAffiliation1 Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, Leuven, Belgium. Affiliation2 Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology Letter 3472 10.4193/Rhin25.634 Skin prick testing (SPT) is the gold standard for diagnosing allergic sensitization in individuals with a suspected airborne allergy. Skin tests are used as first option in 90% of individuals suffering from respiratory allergies and almost two-third of all types of allergies. However, its accuracy highly depends on the operator, causing variability during pricking and readout. S.P.A.T. or skin prick automated test standardises the SPT procedure and has been clinically validated.