94 Chapter 2 Diagnostic accuracy sIgE (D.farinae) Question: Should sIgE (D.farinae) be used to diagnose allergic rhinitis in patients highly suspected of having allergic rhinitis? Bibliography: Haxel, 2016 [2] Sensitivity: 0.84 (95% CI: 0.69 to 0.93) Specificity: 0.52 (95% CI: 0.37 to 0.66) Prevalences 30%* Outcome № of studies (№ of patients) Study design Factors that may decrease certainty of evidence Effect per 1.000 patients tested Test accuracy Certainty of evidence Risk of bias Indirectness Inconsistency Imprecision Publication bias pre-test probability of 30% True positives (patients with allergic rhinitis) 1 studies 97 patients crosssectional (cohort type accuracy study) seriousa seriousb not serious seriousc none 251 (208 to 280) ⨁◯◯◯ VERY LOW False negatives (patients incorrectly classified as not having allergic rhinitis) 49 (20 to 92) True negatives (patients without allergic rhinitis) 1 studies 97 patients crosssectional (cohort type accuracy study) seriousa seriousb not serious seriousc none 363 (262 to 460) ⨁◯◯◯ VERY LOW False positives (patients incorrectly classified as having allergic rhinitis) 337 (240 to 438) * This prevalence was chosen, based on the Dutch clinical guideline on allergic and non-allergic rhinitis for general practitioners [4], and was confirmed in the study of King et al [3] a. Concerns about patient selection and flow & timing due to lack of information b. The included study has been performed in tertiary care. This review focusses on primary care c. Only 64 patients with TP or FN results
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