Prick Test Research Articles

Influence of the Metallic Sublayer on Corrosion Resistance in Hanks' Solution of 316L Stainless Steel Coated with Diamond-like Carbon.

The purpose of the study was to ascertain the corrosion resistance in Hanks' solution of Cr-Ni-Mo stainless steel (AISI 316L) coated with diamond-like carbon (DLC) coatings to establish its suitability for biomedical applications, e.g., as temporary implants. The influence of the carbon coating thickness as well as the correlated effect of the metallic sublayer type and defects present in DLC films on corrosion propagation were discussed. The results obtained were compared with findings on the adhesion of DLC to the steel substrate. The synthesis of carbon thin films with Cr and Ti adhesive sublayers was performed using a combined DC and a high-power-impulse vacuum-arc process. Evaluation of the corrosion resistance was carried out by means of potentiodynamic polarisation tests and scanning electron microscopy. Adhesive properties of the sublayer/DLC coating systems were measured using a scratch tester. It was found that systems with Ti sublayers were less susceptible to the corrosion processes, particularly to pitting. The best anti-corrosion properties were obtained by merging Ti with a DLC coating with a thickness equal to 0.5 μm. The protective properties of the Cr/DLC systems were independent of the carbon coating thickness. On the other hand, the DLC coatings with the Cr sublayer showed better adhesion to the substrate.

COVID-19 vaccines: anaphylaxis and anxiety : Acase study from an allergy unit.

Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) was one crucial element to overcome the coronavirus disease 2019 (COVID-19) pandemic. Even though anaphylaxis to vaccines is rare, 47patients came to the Allergy Unit at the University Hospital Graz, Austria, reporting immediate anaphylactoid symptoms after administration of COVID-19 vaccines. In addition, 29patients with known drug-induced anaphylaxis wanted to be tested for apossible sensitization against COVID-19 vaccines or excipients, such as polyethylene glycol (PEG) or polysorbate80 (PS80) before the first COVID-19 vaccination. Skin prick tests and intradermal tests were performed in all 76patients, mostly using PEG 2000, and/or PS80. Skin prick tests with COVID-19 vaccines were performed depending on availability. Our aim was to characterize this patient cohort in terms of patients' anaphylactoid responses, their willingness to future vaccinations against SARS-Cov‑2, and reasons for their decision. We developed aquestionnaire and analyzed 34completed copies. Of the 47patients with anaphylactoid reactions to COVID-19 vaccination, most were female (40female/7male). The skin tests, even when performed with the respective COVID-19 vaccine, were negative in all but one patient. Most patients who experienced anaphylactoid reactions after aCOVID-19 vaccination, did not want another COVID-19 vaccination at the time of answering the questionnaire because of anxiety for another anaphylactoid response at the next shot. Premedication with antihistamines significantly lowered (n = 74vaccinations) the severity of anaphylactoid responses after COVID-19vaccinations. Anxiety about another anaphylactoid episode hinders patients to be vaccinated against SARS-CoV‑2 again. Premedication with antihistamines and collaboration of allergologists with psychologists might lower the risk of an anaphylactic/anaphylactoid response as well anxiety in drug-induced anaphylactic patients.

Anaphylactic Shock Caused by Eating Buckwheat.

Background: Urticaria is a common disease with a marked influence on quality of life. The key cell involved is the mast cell, which can be activated by a vast variety of stimuli, and the major mediator is histamine. Allergic urticaria is a disorder with a large variety of causes: food, drugs, insect venom, skin contact with allergens, and physical exercise. Buckwheat consumption has increased in European countries and the USA because it is gluten-free. It can trigger anaphylactic shock if ingested, inhaled, or handled with the hands. Five common buckwheat allergens named Fag e1 to 5 (Fag e1, 2, and 3 are considered the major allergens) and two tartary buckwheat allergens named Fag t1 and Fag t2 have been described. Method: We present the case of a patient who experienced two anaphylactic shocks and in whom the etiological factor was buckwheat. The patient presented to the Allergology department for the evaluation of two episodes of severe allergic reactions that required emergency therapy, episodes that involved the loss of consciousness and were of major severity. At each anaphylactic shock, an ambulance was requested, and emergency therapy was administered, leading to the patient's recovery within a few hours. Diagnosis: Since each episode occurred a few minutes after eating, the diagnosis was established based on a detailed anamnesis and prick skin tests, followed by specific IgE dosages. Other foods consumed by the patient, assessed by prick skin testing and specific IgE dosages of suspected foods, were excluded as the etiological cause. Increased levels of buckwheat-specific immunoglobulin E were highlighted, thus identifying the etiological agent. The treatment of anaphylactic shock was performed urgently by the ambulance crew with adrenaline, infusion solutions, cortisone preparations, and antihistamines. Result: Following the treatment that was initiated, there was a partial remission of the lesions after a few hours. Conclusions: Buckwheat allergy is rare, but it produces symptoms that affect the skin, gastrointestinal tract, and respiratory tract, as well as anaphylaxis. In a professional environment, it can trigger allergic rhinitis, asthma, and hives. Although buckwheat allergens have been described, their clinical relevance has only been studied in a small number cases. In current practice, the only commercially available allergen is Beech e2 per the ImmunoCAP ISAC microarray. Diagnosis can be difficult in clinical practice. This reported case suggests the need for a thorough anamnesis, since buckwheat is consumed as a hidden allergen, and in Europe, it is not necessary to label foods containing this allergen.

An Evaluation of Skin and Immunological Responses after Using a Novel Cross-Linked Porcine-Based Dermal Injectable Collagen with Lidocaine for Nasolabial Fold Correction.

Background: Hypersensitivity to the new dermal injectable porcine-based collagen with lidocaine featuring a novel cross-linking technology (test filler) for nasolabial fold correction was compared to the commercially available traditional cross-linked dermal injectable porcine-based collagen with lidocaine (control filler). Methods: Recruited participants (n = 279) received a single 0.1 mL intradermal injection of either test filler or control filler in the left forearm as a screening skin allergy test. Injection sites were assessed clinically at 24 h post-implant. Treatment was given to 252 successfully screened participants, and injection sites were monitored for 21 days. Immunological examinations were performed at screening and then at 4 and 24 weeks post-treatment. Observations for adverse events continued until the 52nd week. Results: Intradermal allergy testing results were negative for all the test recipients (0/124) and positive for two control recipients (2/132, 1.5%). Most of the participants exhibited no changes in serum immunoglobulin (IgG, IgM) and complement (C3, C4) levels. No serious adverse events related to the device were recorded. Most adverse events were common complications of dermal filler treatment and were related to the injection site. Most adverse effects were resolved or under control by 52 weeks. Conclusions: Hypersensitivity reactions with the test filler were lower than those with the control filler, validating the safe use of test filler for nasolabial fold correction without the need for pretreatment skin testing.

Microstructural and mechanical characterization of chromium carbide layers obtained on 100Cr6 and X200Cr12 steels by conversion

Carbides and Nitrides of transition metals are widely used due to their interesting properties. Several deposition methods and techniques can be used to produce carbide and nitride coatings. The choice of how to make the deposit depends on several parameters such as, the conditions of use of these deposits, the thickness to be produced, the adhesion between the substrate the deposit, and the cost. In this work, hard coatings of chromium carbide were produced by a conversion treatment on 100Cr6 and X200Cr12 steels. The conversion treatment consists of electrode position of chromium on the surface of 100Cr6 and X200Cr12 steels followed by diffusion annealing treatment at 1000 and 1100 °C for holding times of 1 and 2 hours. The obtained results show that, for all the conversion treatments carried out in this work, there was formation of chromium carbides layer on the surface of steel. However, it should be noted that the nature of the constituting phases of the formed layer depends on the temperature of the diffusion annealing treatment and the duration at this temperature. It should also be noted that the X-ray diffraction analysis has allowed us to show the existence of chromium oxide in addition to chromium carbides. The microhardness profile and the scratch test show that the X200Cr12 steel sample shows better results.These properties are usually obtained by expensive methods such as PVD, CVD, while we can obtain them by easy and inexpensive methods.

Successful Introduction of Peanut in Sensitized Infants With Reported Reactions at Home

Background and objectivePrevious studies have shown efficacy of early introduction of peanut to prevent peanut allergy. It is currently unknown which diagnostic pathway is optimal after parental-reported reactions to peanut at home after early introduction. MethodsThe PeanutNL cohort study included high-risk infants that were referred for early introduction of peanut. A subgroup of 186 infants with reactions to peanut at home underwent peanut skin prick tests and a supervised open oral food challenge (OFC) at a median age of 8 months. After a negative OFC, peanut was introduced at home. ResultsSensitization to peanut was detected in 69% of 186 infants, of which 80% had > 4mm wheals in skin prick tests. An OFC with a cumulative dose of 4.4 gr peanut protein was performed in 163 infants with Sampson severity score grade I-III reactions at home; 120 challenges were negative. Peanut was subsequently introduced at home in infants with a negative challenge outcome. After 6 months, 96% were still eating peanut and 81% ate single portions of 3.0 gr peanut protein. One patient was considered to be peanut allergic after reintroduction of peanut at home. ConclusionThese data show that 65% of infants with reported reactions to peanut at home have negative OFCs. In those children, peanut could be introduced safely and 96% were able to consume peanut regularly without reactions. Challenging infants under 12 months of age prevents the misdiagnosis of peanut allergy, and enables safe continued exposure to peanut and the induction of long-term tolerance.

Effect of Ag coatings prepared by magnetron sputtering on the wear properties of Ti6Al4V alloy

Abstract Ag coatings were prepared on the surface of Ti6Al4V alloy by magnetron sputtering technique, and the effects of different Ag target power and sputtering time on the coating properties were investigated. The coating thickness was firstly measured by a step meter, and then the coatings obtained under different parameters were characterized by Vickers hardness tester, scratch tester, and friction wear tester. The variation in the furnace temperature had a significant effect on the hardness of the coatings: the coating thickness increased slightly with increasing temperature, but the increase was not dramatical. The Vickers hardness of the coatings showed a tendency to increase and then decrease with increasing temperature, reaching a peak at 150 °C. The hardness of the coatings was found to increase with increasing temperature and then decrease with increasing temperature. Scratch tests further showed that the coatings prepared in the range of 150 °C to 180 °C exhibited superior bond strength with the substrate. The wear morphology of the coatings showed that the coatings prepared at 150 °C had the best wear resistance. At this temperature, the flaking of the coating due to adhesive wear was significantly reduced, and the depth of scratches due to abrasive wear was also reduced. The variation of the Ag target power also had a significant effect on the hardness of the coatings. As the target power increases, the coating thickness increases significantly, and the Vickers hardness increases and then decreases, reaching a maximum at 12 W. The coatings prepared at 10 W show better performance in terms of scratch and wear patterns. These experimental results provide strong data support for the subsequent preparation of Ti6Al4V joint prostheses.

Quercetin activates autophagy in the distal ischemic area of random skin flaps through Beclin1 to enhance the adaptability to energy deficiency

Random flaps are frequently employed in treating substantial skin abnormalities and in surgical tissue-rebuilding interventions. The random flap technique provides flaps of specific dimensions and contours to fit the surgical incision. However, blood supply deficiency and subsequent ischemia-reperfusion injury can cause severe oxidative stress and apoptosis, eventually leading to distal necrosis, which limits the clinical application of the flap. Quercetin (QUE) is primarily found in the glycoside form in many plant parts, such as stem bark, flowers, leaves, buds, seeds, and fruits. Cellular, animal, and clinical studies have demonstrated the antioxidant, anti-apoptosis, anti-inflammatory, and activation of autophagy properties of QUE. In previous studies, high doses of QUE effectively suppressed the survival of human umbilical vein endothelial cells (HUVECs) stimulated by hydrogen peroxide. However, different concentration gradients of QUE on HUVECs revealed a significant protective effect at a concentration of 10 mM. The protective impact of QUE on HUVECs was evaluated using scratch tests, CCK-8 assays, and EDU assays. Simultaneously, a mouse model of random skin flap was created, and the impact of QUE on skin flap survival was examined by intragastric injection. The QUE group showed a significantly larger survival area of the random flap and higher blood flow intensity compared to the control group. Furthermore, the beneficial effects of QUE were reversed by the autophagy inhibitor 3-MA. Therefore, autophagy plays a significant role in the therapeutic benefits of QUE on flap survival.

Preparation of electroless deposition of NiTiZr(P) quaternary alloy and their properties

The exceptional super elasticity and corrosion-resistance of Ni-Ti alloys have attracted a lot of attention and interest lately for a wide range of applications, and complex alloy components could be prepared effectively by different preparation techniques. Ni(P), Ni-Ti(P), Ni-Zr(P), and Ni-Ti -Zr(P) binary, ternary, and quaternary alloys were coated on mild steel by electroless deposition which is a method of plating metallic films on a substrate by the reduction of metallic complex ions in solution with the aid of reducing agent from an alkaline bath. The ternary Ni-Ti-Zr(P) alloy is considered to be one of the most promising high-temperature SMAs. SEM, XRD and EDS were used to examine the morphology, phase composition and elemental composition which demonstrate the microstructure of the deposits. The mechanical characteristics of the samples were examined through scratch test and micro hardness analysis and the value increased from 261 HV200 to 405 HV200 and that the coefficient of friction raised significantly from 0.23 to 3.5 owing to the presences of added elements in Ni(P) matrix. Polarization analysis and EIS were tested to evaluate the corrosion properties of coated samples in a non-deaerated 3.5 %wt. (NaCl) solution. The outcomes indicate that as the amount of Ti-Zr elements in the bath raised, the corrosion potential became more positive and the corrosion current density decreased to 14.903 μA/cm2. Furthermore, Ni-Ti-Zr(P) alloy coating strengthens corrosion resistance in comparison to Ni(P).

High extracellular matrix stiffness promotes the metastasis of nasopharyngeal carcinoma through STAT3/FGF1 positive feedback regulation activated by JAK2

The stiffness of the extracellular matrix (EM) is known to be associated with tumor metastasis. This study aims to clarify the function and mechanisms of EM stiffness in nasopharyngeal carcinoma (NPC) and to provide a potential therapeutic target for patients with NPC. The NPC cell lines were cultured under varying stiffnesses. Plate cloning, Transwell assays and scratch tests were conducted to compare the phenotypes. Transcriptome sequencing and enrichment analysis were performed to explore the key molecules and the downstream signaling pathways, which were verified via in vitro and in vivo experiments. Our study showed that the NPC cells cultured on a stiff substrate (50 ​kPa) had greater colony formation, invasion and migration abilities than those cultured on a soft substrate. Transcriptome sequencing showed that a stiff environment induced high expression of fibroblast growth factor 1 (FGF1), which suggested a poor prognosis in various malignancies. The phosphatidylinositol 3-kinase (PI3K)-Akt signaling pathway played an important role in NPC metastasis activated by the FGF1 autocrine pathway in a stiff environment. The increased FGF1 expression was regulated by the transcription factor STAT3, and a positive feedback regulation between them was observed. The use of the JAK inhibitor Ruxolitinib and JAK2 interference inhibited the activation of STAT3. In conclusion, JAK2 activates STAT3/FGF1 positive feedback regulation and promotes NPC metastasis via the PI3K/Akt signaling pathway in a high-stiffness environment. Hence, FGF1 can be used as a potential therapeutic target for patients with NPC.

53074 The usefulness of skin prick and patch testing for local anesthetics in clinical practice for patients with sulfite allergy

53074 The usefulness of skin prick and patch testing for local anesthetics in clinical practice for patients with sulfite allergy

Deformation Behavior of Alloys Based on Iron and Manganese in Scratch, Tensile, and Indentation Tests

Deformation Behavior of Alloys Based on Iron and Manganese in Scratch, Tensile, and Indentation Tests

The Diagnosis of Allergy to Lipid Transfer Proteins.

To provide an update on the diagnosis of non-specific Lipid Transfer Protein (nsLTP) allergy. More publications report the presence of nsLTP allergy in Northern European countries and nsLTP sensitisation in children. Individuals are more likely to have severe reactions if there is recognition of increasing numbers of LTP components. Diagnosis is problematic; not all those with nsLTP allergy will have a positive test to a peach extract containing Pru p 3, the peach nsLTP. Sensitisation to nsLTP is being reported in more countries, including to the nsLTP in Cannabis Sativa in North America. Meals containing multiple nsLTP foods are more likely to be involved in co-factor reactions. Component-resolved diagnostics are superior to skin prick tests, to determine sensitisation to the individual nsLTP allergens causing symptoms and, in the future, the Basophil Activation test may best discriminate between sensitization and clinical allergy.

FT-IR Analysis Results of Rolling and Temperature Effects on Flexible Substrate

Abstract This research investigates the complexities of molecular structural analysis applied to film substrates post the rolling process, concentrating specifically on characterizing flexible substrate materials, particularly polyimide (PI) film. By deliberately adjusting the number of rolling cycles and temperature parameters, a meticulous series of scratch tests was conducted. Following this, comprehensive sample analyses were carried out employing Fourier Transform Infrared (FT-IR) spectroscopy, enabling a thorough exploration of the molecular composition and structural integrity of the substrates. Our experimental findings confirm that molecules with weaker bonds tend to dissociate under physical stresses like rolling. While the dissociation of bonds does not strictly correlate proportionally with the frequency of stress application, a weakening of bonds is observed, particularly after repeated stress applications, indicating the susceptibility of molecular bonds to external stress.

Fabrication of FeCoNi alloy film via friction-assisted selective area electrodeposition

Nowadays, carbon neutrality target has been receiving a growing attention in academia and industry. In many industry applications, the wear and fatigue damages of bearing components are the frequent failures affecting machine operation. The maintenance and replacement of damaged bearings cause enormous cost in the aspects of consumptions of energy and materials. In this study, a novel technique of friction-assisted electrodeposition (FAED) is firstly demonstrated for surface remanufacturing of worn bearing races. By using the FAED technique, FeCoNi alloys with nanocrystalline were successfully deposited on the selective surface zone. The surface morphology, microstructure feature as well as mechanical properties of the deposited FeCoNi film were quantitatively characterized. The results have indicated that friction load and electrodeposition time have a remarkable effect on the microstructure of the film and its surface finish. The cross-section exhibited a uniform distribution of Fe, Co and Ni. Meanwhile, typical amorphous and polycrystalline features were observed within the deposited film. Additionally, the as-deposited layer shows desired mechanical properties, including hardness, complex modulus and friction coefficient, matching with those of the GCr15 substrate. Scratch test results showed that a good bonding strength between the coating and the bearing steel was achieved. Moreover, the role of friction in the electrodeposition process has been analyzed. This work provides a new route to achieve selective area electrodeposition of alloy films on bearing steel, which can be further developed for metal surface repairing.

Effect of deposition parameters on structural and mechanical properties of Novel h-BN doped TiCrNbN coatings

In this paper, the novel h-BN doped TiCrNbN thin films was deposited on the DIN 1.2714 steel using closed field unbalanced magnetron sputtering (CFUBMS) technique with variable working pressure, bias voltage, and LaB6 target voltage. The main goal is to determine the contribution of degrees of these parameters on structural and mechanical properties using Analysis of Variance (ANOVA). The deposition parameters were leveled based on L9 (33) orthogonal Taguchi design method. Microstructural and thickness of coatings were investigated using SEM. The coatings had granular and flawless surface properties. The thickness of the coatings was determined in the range of 874 nm and 1.69 μm. The deposition parameter that has the highest contribution to coating thickness is working pressure. Hardness and adhesion strength of coatings were determined employing nanohardness and scratch tester, respectively. The highest hardness among the coatings was 24.67 GPa, obtained with the 3x10-3 Torr working pressure, 100 V bias voltage and 600 V LaB6 target voltage parameters. The deposition parameter that has the highest contribution to hardness is working pressure. The coating conditions with the highest hardness exhibited the highest adhesion strength. The superiority of the contribution of working pressure on the adhesion strength was prominent compared to other parameters.

Resolving high-strain-rate scratch behavior of Ti6Al4V in experiment and meshless simulation

The outstanding strength-to-weight ratio and corrosion resistance of titanium have made it the material of choice in the aerospace industry and medicine. The alpha–beta alloy Ti6Al4V is particularly preferred for its excellent mechanical and bio-compatible properties. Despite its advantages, the low thermal conductivity and poor tribological performance of titanium pose significant challenges during manufacturing and in operation. This research offers deep insights into the high strain rate behavior of Ti6Al4V under abrasive load, such as e.g. experienced in machining, by modifying the standard scratch test setup and using optimized Johnson–Cook material parameters to perform Material Point Method (MPM) simulations. The MPM simulations provide accurate predictions of the data gathered through high strain rate scratch experiments. We found an increase in the von Mises stress distribution as well as the normal and tangential forces required to perform a scratch of the same depth as the strain rate increases. The morphology of the scratch profiles also showed an increase in the height of the ridges that form as the scratching speed increases. These findings are in line with the increase in yield strength and work hardening with growing strain rate. This study bridges the gap between simulation models and experimental observations by providing insights for improved machining strategies and surface treatments that can enhance the performance of Ti6Al4V in demanding applications.

Impact of deposition pressure on the structural, nanomechanical, and tribological properties of δ-TaN coatings deposited via magnetron sputtering on Ti6Al7Nb alloy

In the present study, δ-TaN thin films were deposited by reactive magnetron sputtering (physical vapour deposition) on Ti6Al7Nb alloy by varying the deposition pressure (0.8–0.2 Pa). Their crystalline structure, chemical composition, surface roughness, and surface morphology were investigated by using grazing incidence X-ray diffraction, energy dispersive spectroscopy, scanning probe microscope, and field emission scanning electron microscopy (FESEM), respectively. Structural analysis results confirmed the deposition of cubic δ-TaN thin films along the (111) basal plane; moreover, spherical dome-like surface morphology was observed by FESEM. Further, to analyze the nanomechanical properties of the deposited δ-TaN coatings, such as hardness (H) and modulus (E), scratch tests were performed utilizing the nanomechanical system. Moreover, friction and wear properties of the coating and bare sample (substrate) were investigated on nano-tribometer equipment using a rotary ball-on-disk type configuration. The stainless steel (SS-316) and silicon nitride (Si3N4) balls were used as the counter materials for the tribological tests. The observations of nanomechanical tests revealed that H (GPa), E (GPa), and H/E ratio values increased from 11.83 to 28.30 GPa, 176.02 to 248.45 GPa, and 0.06 to 0.11, respectively, with the decrease of the deposition pressure. In the scratch test, the highest critical load (cohesion failure) was found for δ-TaN coating deposited at the lowest deposition pressure (0.2 Pa). Tribological results of δ-TaN coatings demonstrated average coefficient of friction (COF) value ranges between 0.066–0.092 and 0.072–0.029 against steel and Si3N4 balls, respectively. The wear rate values were observed to vary from 8.15 × 10−5 to 7.56 × 10−6 and from 1.77 × 10−3 to 8.99 × 10−6 against steel and Si3N4 balls, respectively. Generally, the average COF and wear rate decreased against 316 SS and Si3N4 balls as the deposition pressure of coatings decreased. However, the coating deposited at 0.8 and 0.6 Pa against Si3N4 ball showed early delamination of the coating, resulting in the sudden fluctuation in COF plots and higher wear rate in the range of 10−3 mm3/N.m.

Peanut allergen characterization and allergenicity throughout development.

Peanut allergy (PA) in children is a major concern. There is a need for better biological material for both diagnosis and oral immunotherapy (OIT) treatments. The unique state of seeds at early reproductive stages may affect the allergenicity of storage proteins, and impact clinical diagnostic and OIT protocols. The objective of this study was to evaluate the major allergen content in sequential seed developmental stages and monitor allergenicity via specific IgE binding quantification and skin prick testing. Seeds were collected from peanut plants and sorted into five developmental stages: initial (S1), developing (S2), full-size without coloration (S3), full-size with coloration (S4), and fully mature (S5) seeds. Samples were characterized by RNA-Seq, ELISA, and immunohistochemistry. Lyophilized, ground preparations were used for evaluation of skin test responses in sixty challenge-proven PA children. Gene expression, protein content, and specific IgE binding of allergenic proteins increased throughout seed maturation and development. An expression bias towards the less allergenic A-genome copy of the major allergen Ara h 2 was found in earlier stages, especially in stage S2. Immunohistochemical staining showed that Ara h 2 is more dispersed in the cell and less accumulated within organized bodies at stage S2 versus stage S4. Significant differences were found in mean wheal responses between the commercial peanut extract (equivalent to stage S5) and stages S1 and S2, but not with stage S4, upon skin prick testing in subjects with PA. The observed decrease in peanut-specific IgE binding of immature peanut seeds may be a result not only of decreased amounts of allergenic proteins, but also of profound changes in seed composition and conformation. This may be significant for developing a safer and more effective peanut OIT protocol.

Cost-consequence analysis of computer vision-based skin prick tests: implications for cost containment in Switzerland

BackgroundSkin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs.MethodsWe conducted a cost-consequence analysis from a hospital’s perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital, whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision-based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty.ResultsThe difference in average cost between the two alternatives from a hospital’s perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs.ConclusionAgainst the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study.