Scientific Study

Background: The Peanut Allergy Prediction Web Tool is a newly developed online aid, which calculates the probability of an individual's allergic reaction based on their SPT, Ara h 2-specific IgE (Ara h 2-sIgE) and/or basophil activation test (BAT) results. Objective: To validate the diagnostic performance of the online tool and assess its ability to discriminate between peanut-allergic (PA) and peanut-sensitised tolerant (PST) cases. Methods: Demographical data, clinical history, results for SPT, Ara h 2-sIgE, BAT and oral food challenge (OFC) outcomes were collected for paediatric cases with a confirmed peanut allergy status (PA or PST). Receiver operating characteristic (ROC) curve analysis, area under the curve (AUC) and sensitivity (S), specificity (Sp) positive and negative predictive values (PPV and NPV) were determined to assess the diagnostic performance of the tool using variations of one, two or three test results. Results: AUC value for all test results combinations exhibited excellent degrees of discriminative performance between PA and PST individuals. The BAT was the greatest single test performer (AUC=0.945; S=85%; Sp=97%; PPV=99%; NPV=71%). The two-test combination of Ara h 2-sIgE and BAT, (AUC=0.959; S=87%; Sp=97%; PPV=99%; NPV=74%) and the three-test combination (AUC=0.949; S=88%; Sp=89%; PPV=96%; NPV=74%) demonstrated the highest discriminatory ability and diagnostic accuracy. Conclusion: The Peanut Allergy Prediction Web Tool's diagnostic performance proves highly accurate using several different combinations of test results when classifying PA and PST cases. Future validation is needed to assess the tool's performance in predicting PA severity in comparison to OFC outcomes.

https://doi.org/10.1016/j.jaip.2025.05.016