Abstract
ObjectiveTo establish a next-generation reference interval (RI) for total IgE (tIgE) and evaluate its usefulness. MethodsA new allergen-specific IgE (sIgE)-based tIgE RI, including a continuous RI in children, was established using the NHANES 2005–2006 project. The usefulness of the RI was evaluated by sensitivity (Sen), specificity (Spec), positive predictive value (PPV), negative predictive value (NPV), κ coefficient and consistency. ResultsThe new tIgE RI showed better performance in identifying allergic sensitization (Sen 0.53, Spec 0.90, PPV 0.83, NPV 0.68, κ 0.44, consistency 0.72) than allergic diseases (Sen 0.37, Spec 0.75, PPV 0.55, NPV 0.60, κ 0.13, consistency 0.59). The 2014 U.S. tIgE RI was more effective in identifying allergic diseases (consistency 0.63 vs. 0.54, P<0.001) but less accurate in identifying allergic sensitization (consistency 0.59 vs. 0.67, P<0.001) in children than in adults. The new RI improved the accuracy of identifying allergic sensitization in children to a level similar to that in adults (consistency 0.72 vs 0.73, P=0.37) and maintained its advantage in identifying allergic diseases in children (consistency 0.64 vs 0.55, P<0.001). ConclusionsThe established next-generation tIgE RI is useful for identifying allergic sensitization, especially in children.
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