***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Allergy test results can differ based on the method used . The most common tests include skin-prick testing ( SPT ) and in vitro tests to detect allergen-specific IgE. This study was design ed to assess allergy test results using SPT , individual specific IgE tests , and a multiallergen IgE assay ( multiple allergen simultaneous test ) in patients with chronic rhinitis and controls . Methods One hundred forty total patients were prospect ively enrolled in the study , including 100 patients with chronic rhinitis and 40 control patients without atopy . All eligible patients underwent SPT , serum analysis using individual specific IgE test , and multiple allergen simultaneous test against 10 common allergens . Allergy test results were then compared to identify correlation and interest agreement . Results There was an 81–97 % agreement between SPT and individual specific IgE test in allergen detection and an 80–98 % agreement between SPT and multiple allergen simultaneous test . Individual specific IgE test and multiple allergen simultaneous test allergy detection prevalence was generally similar to SPT in patients with chronic rhinitis . All control patients had negative SPT ( 0/40 ) , but low positive results were found with both individual specific IgE test ( 5–12.5 % ) and multiple allergen simultaneous test ( 2.5–7.5 % ) to some allergens , especially cockroach , Dermatophagoides farina , and ragweed . Agreement and correlation between individual specific IgE test and multiple allergen simultaneous test were good to excellent for a majority of tested allergens . Conclusion This study shows good agreement and correlation between SPT with individual specific IgE test and multiple allergen simultaneous test on a majority of the tested allergens for patients with chronic rhinitis . Comparing the two in vitro tests , individual specific IgE test agrees with SPT better than multiple allergen simultaneous test Background Grass allergen immunotherapy ( AIT ) reduces symptom severity in seasonal allergic rhinoconjunctivitis ( ARC ) but its impact on general health-related utility has not been characterised for the purpose s of economic evaluation . The aim of this study was to model the preferred measure of utility , EQ-5D index , from symptom severity and estimate incremental quality adjusted life years ( QALYs ) associated with SQ-st and ardised grass immunotherapy tablet ( GRAZAX ® , 75,000 SQ-T/2,800 BAU , ALK , Denmark ) . Methods Data were analysed from five consecutive pollen seasons in a r and omised placebo controlled trial of GRAZAX ® . Binomial and Gaussian mixed effects modelling related weekly EQ-5D index score to daily symptom and medication scores ( DSS & DMS respectively ) . In turn , daily EQ-5D index was estimated from ARC symptoms and medication use . Results DSS and DMS were the principal predictors of ‘ perfect ’ health ( EQ-5D = 1.000 ; binomial ) and ‘ imperfect ’ health ( EQ-5D < 1.000 ; Gaussian ) . Each unit increase in DSS and DMS reduced the odds of ‘ perfect ’ health ( EQ-5D = 1.000 ) by 27 % and 16 % respectively , and reduced ‘ imperfect ’ health by 0.17 and 0.13 , respectively . Gender remained the only other significant main fixed effect ( Male odds ratio [ OR ] = 1.82 ) . Incremental estimated EQ-5D index utility  for GRAZAX ® was observed from day -30 to day + 70 of the pooled pollen season ; mean daily utility for GRAZAX ® = 0.938 units ( 95%CI 0.932 - 0.943 ) vs. 0.914 ( 0.907 - 0.921 ) for placebo , an incremental difference of 0.0238 ( p < 0.001 ) . This translates into an incremental 0.0324 Quality Adjusted Life Years over the five year study period . Conclusions ARC symptoms and medication use are the main predictors of EQ-5D index . The incremental QALYs observed for GRAZAX ® may not fully describe the health benefits of this treatment , suggesting that economic modelling may be conservative Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND The sensitisation profile at molecular level in plant-food allergy is complex . Several allergens may be involved , with different potential for severe reactions . lipid transfer proteins ( LTP ) are considered the most relevant plant-food allergens in adults in Mediterranean countries , but less is known in children . AIM To describe the clinical pattern and sensitisation profile of children with plant-food allergy and LTP sensitisation from Northeast Spain . METHODS Children with history of immediate reaction to plant-food(s ) , positive skin-prick-test to the culprit plant-food(s ) and specific-IgE to plant-food LTPs were analysed . RESULTS 130 children were included . 69.2 % ( 90/130 ) had reacted to ≥2 taxonomically unrelated plant-foods . Peach , walnut , hazelnut and peanut were most frequently involved . Reactions severity ranged from anaphylaxis ( 45.4 % , 59/130 ) to oral symptoms only . Sensitisation to a particular plant-food LTP not always caused clinical symptoms with that plant-food ; 69 % ( 40/58 ) and 63 % ( 17/27 ) of peach- and walnut-tolerant subjects had positive rPru p 3 and nJug r 3 specific IgE , respectively . 65.4 % ( 85/130 ) of children were also sensitised to storage proteins , which was associated to anaphylaxis and nut allergy . However , 60 % of patients without nuts/seeds allergy were sensitised to storage proteins . Specific-IgE levels to LTPs and /or storage proteins were not useful to predict allergy ( vs. tolerance ) to peach , walnut , peanut or hazelnut . CONCLUSIONS Sensitisation to LTP and /or storage proteins without clear clinical significance is relatively common . Prospect i ve longitudinal studies are required to evaluate the relevance of these silent sensitisations over time . Caution is required when interpreting the results of molecular-based diagnostic tools in clinical practice Background One fourth of the adult population in Europe suffer from respiratory allergy . Subcutaneous-allergen-specific-immunotherapy ( SCIT ) has long-term disease modifying effect on disease specific Health-Related Quality of Life ( HRQoL ) . The purpose of this study was to assess the effect of SCIT on alternative disease outcomes in patients with grass-pollen and /or house dust mite induced allergic rhino-conjunctivitis and /or an asthma diagnosis . Focus was on expressing outcomes in terms of generic quality of life ( Quality -Adjusted-Life-Years ( QALY ) ) and reductions in sick days . Methods The study was a multi-centre study with prospect i ve follow-up . 248 patients were initiated on SCIT .  The disease specific Rhino-conjunctivitis Quality of Life Question naire ( RQLQ ) and two generic ( HRQoL ) instruments 15D and EQ-5D were used at baseline and at follow-up . The outcome measures included change in ; disease severity , RQLQ-scores , number of days with symptoms- and number of sick days per year and finally changes in generic HRQoL and thus , QALY . Disease severity was assessed by specialist doctors ; severity of rhino-conjunctivitis was classified according to the Allergic Rhinitis and its Impact on Asthma ( ARIA ) and asthma severity according to the Global Initiative for Asthma ( GINA guideline ) . The remaining outcome measures were assessed by the patients in question naires at baseline and at follow-up . An intension to treat approach was applied . For missing items imputation of sample mean base-line values or follow-up values were used after specified criteria . The effect of SCIT on rhino-conjunctivitis and /or asthma diagnoses was analysed at follow-up using three logistic regression models . Results The disease severity showed significantly improved disease control . Mean RQLQ-score was reduced from 3.02 at baseline to 2.00 at follow-up . Average annual days with symptoms were reduced from 189 to 145 days whilst annual sick days were reduced from 3.7 to 1.2 days . The 15D-score increased from 0.83 to 0.86 and the EQ-5D-score from 0.70 to 0.77 , which indicated an annual gain per patient of 0.03 - 0.06 QALY . Conclusions Allergic patients suffering from rhino-conjunctivitis alone or rhino-conjunctivitis and asthma experience significantly increased HRQoL and they gain 0.03 - 0.06 QALY , when treated with SCIT for one year . Trial registration The study was registered at Clinical Trials.gov with the identifier : NCT01486498 BACKGROUND Allergic rhinoconjunctivitis is a global health problem . Around 14 million people in Spain , France , Italy , and Austria suffer from grass pollen induced allergic rhinitis . St and ard care only provides symptoms relief , while allergen specific immunotherapy ( SIT ) treats the underlying cause of the disease . Grazax from ALK-Abelló is a new , tablet-based , effective route of SIT for home treatment . The objective was to assess the cost-effectiveness of Grazax in four Southern European countries . METHODS A prospect i ve pharmacoeconomic analyses was carried out alongside a multinational , clinical trial measuring the efficacy of Grazax . Pooled data on re source use and health outcomes were collected . A societal perspective was adopted , and the analysis had a nine-year time horizon . The primary outcome measure was quality adjusted life years ( QALYs ) . RESULTS Grazax was superior to st and ard care for all efficacy endpoints , including QALYs gained , and result ed in significantly less use of rescue medication and fewer hours missed from work .  Grazax was cost-effective for all countries for an annual price in the range of 1500 euros - 1900 euros . The result was improved by inclusion of future costs of asthma and exclusion of Spanish trial centers which experienced an exceptionally low pollen season . CONCLUSION The analysis illustrates that allergen SIT with Grazax for grass pollen induced rhinoconjunctivitis is a cost-effective intervention in Southern Europe The objective of this study was to develop and test a health‐related quality of life question naire for clinical trials in rhinoconjunctivitis . The Rhinoconjunctivitis Quality of Life Question naire ( RQLQ ) was developed by asking patients to identify areas of their lives affected by rhinoconjunctivitis . The result ant RQLQ was tested for reproducibility , responsiveness and validity in a r and omized , double‐blind trial of regular versus ‘ as required ’ aqueous beclomethasone dipropionate ( BDP ) nasal spray in ragweed pollen‐induced rhinoconjunctivitis . Eighty‐five patients from previous rhinoconjunctivitis studies participated in the developmental survey . Sixty ragweed‐sensitive patients , from previous trials and media notices , were enrolled in the clinical trial . Aqueous BDP ( 800 μg ) nasal spray was administered regularly or ‘ as required ’ throughout the ragweed pollen season . The survey revealed that , in addition to local symptoms of rhinoconjunctivitis , patients experienced impairment of quality of life through systemic symptoms , sleep disturbance , practical problems , activity limitations and emotional problems . The RQLQ includes 28 questions related to these dimensions . Repeated administration of the RQLQ demonstrated good reproducibility . During the clinical trial , the RQLQ proved responsive in its ability to distinguish between regular and ‘ as required ’ medication use . Validity was shown by moderate to strong relations between changes in symptom diary scores and changes in RQLQ scores . In conclusion the RQLQ is likely to prove useful as a measure of health‐related quality of life in clinical trials in both rhinoconjunctivitis and rhinitis Background : Currently , the diagnosis of IgE‐mediated allergy is based on allergen‐specific history and diagnostic procedures using natural allergen extracts for in vivo and in vitro tests OBJECTIVES /HYPOTHESIS Health utility value ( HUV ) is an index used to measure health-related quality of life for the valuation and comparison of treatments . The Euroqol 5-Dimension ( EQ-5D ) question naire is a widely used method for determining HUV , but it has not been applied for this purpose in patients with chronic rhinosinusitis ( CRS ) who undergo sinus surgery . STUDY DESIGN Prospect i ve cohort study . METHODS Patients with CRS , who were recruited from 11 different otolaryngologic practice s , completed the EQ-5D question naire at baseline , as well as 3 , 12 , and 24 months after surgery . HUVs calculated from the results of this question naire were compared to those reported in the general U.S. population and to patients suffering from other chronic diseases . RESULTS Baseline EQ-5D surveys were completed by 242 patients .  Mean baseline HUV ( st and ard deviation ) was 0.81 ( 0.13 ) . Female gender , revision surgery , and the use of intraoperative image guidance were associated was significantly lower baseline values . HUV rose at 3 months to 0.89 ( 0.12 ) and remained improved at 12 months 0.88 ( 0.10 ) and 24 
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The very limited available data indicated that the addition of multiplex allergen testing [ ImmunoCAP ( ® ) Immuno Solid-phase Allergen Chip ( ISAC ) , Thermo Fisher Scientific/Phadia AB , Uppsala , Sweden ] to st and ard diagnostic work-up can change the clinicians ' views on the diagnosis , management and treatment of patients .
There was some indication that the use of ImmunoCAP ISAC testing may be useful to guide decisions on the discontinuation of restrictive diets , the content of allergen-specific immunotherapy ( SIT ) prescriptions , and whether or not patients should receive SIT .
There was some evidence that ImmunoCAP ISAC may be useful for discriminating allergens that are structurally similar and are recognised by the same IgE antibody ( cross-immunoreactive ) .
Detailed cost analyses suggested that multiplex allergen testing would have to result in a substantial reduction of the proportions of patients receiving single IgE testing and oral food challenge tests in order to be cost-saving in the short term .