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Table 1 Comparison of advantages and disadvantages of common allergy test methods

From: Skin prick/puncture testing in North America: a call for standards and consistency

Type of testing Test method advantages Test method disadvantages
SPT • Minimally invasive • Can be uncomfortable for some patients
• Less patient discomfort than ID testing • Can be contraindicated in patients with extensive skin disease, those taking certain drugs that cannot be discontinued, or those with a recent history of anaphylaxis or current pregnancy
• Sensitive discrimination between positive and negative results
• When properly performed, results are highly specific
• Multiple allergens can be tested at one time
• Lower rate of systemic effects than intradermal testing  
• Results available in 15 to 20 minutes  
• Better correlation with allergy symptoms than in vitro test results  
• Relatively inexpensive  
Intradermal Testing • More sensitive than SPT testing • Is generally less well tolerated than SPT
• May be more reproducible than SPT testing • Takes longer to perform than SPT
• Provides more information on the relative sensitivity of the patient to each allergen tested • May provide more false positive results than SPT
• Results available in 15 to 20 minutes • Requires more technical skill to deliver intradermal injections than SPT
  • Greater risk of systemic reactions than SPT testing & should only be used after a negative SPT result
• Like SPT, can be contraindicated in patients with extensive skin disease, those taking certain drugs that cannot be discontinued, or those with a recent history of anaphylaxis or current pregnancy
In vitro testing • Single blood draw may be more comfortable for some patients than skin testing • Results correlate with clinical status less well than in vivo test methods
• Eliminates possibility of systemic reactions • Results from different methods may not correlate well with each other
• Can be used on patients who have skin disease that interferes with skin testing • No standardized reporting of sIgE test results available; this can mask problems with inter-assay variability
• Can identify sensitivity to cross-reacting allergens
• Turn-around time for results longer than skin testing
• May be more expensive than skin test methods