| Allergic rhinitis and associated co-morbidities such as sinusitis, conjunctivitis, and asthma can significantly decrease patient health related quality of life and impose substantial economic costs. The etiology for rhinitis is complex, therefore efficient management of patient symptoms requires a correct objective diagnosis. Diagnosis of allergic rhinitis is often made through patient history and physical exam, with skin prick or in vitro testing providing a physician with additional information concerning the patient's allergic state. In this work, we investigated the sensitivity and specificity of certain in vitro tested allergens (i.e., cat and common ragweed) in the absence of a gold standard. In addition, the association between patient demographics, in vitro based disease classification and allergy-related medical charges, prescription charges, productivity, and quality of life were explored.;The population for this study (n = 330) included enrollees from a Midwestern managed care organization who had in vitro testing for inhalant allergies. In vitro laboratory results, along with medical and prescription claims associated with allergic rhinitis, were obtained from the managed care's database. In addition to obtaining laboratory test results and claims data, patients were asked to complete a survey containing severity of symptoms, productivity, and quality of life questions.;A total of 232 subjects returned surveys, yielding a 70% response rate. Of the 232 subjects, 170 returned useable surveys (51% response rate of total subjects). The sensitivity and specificity of in vitro allergy testing for cat were calculated to be 72.4% (credible interval: 66.0%--78.3%) and 93.5% (credible interval: 91.8%--95.0%), respectively. The sensitivity and specificity of in vitro allergy testing for short ragweed were estimated to be 47.9% (credible interval: 34.8%--0 61.0%) and 98.5% (credible interval: 34.8%--61.0%). In vitro test status, age, gender, race, and severity of symptoms did not significantly explain allergy-related medical or prescription charges, however, overall allergy work impairment was positively associated with symptom severity. Additionally, study subjects had lower overall mental quality of life when compared to the average U.S. population. Further research is needed to assess the direct impact in vitro allergy testing has on medical costs, productivity, and quality of life. |
