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A cross-sectional study was conducted on 122 adult AR patients (18\u201360 years). Participants underwent SPT, sIgE measurement, and NPT for Der p and Der f. Correlations between SPT, sIgE, and NPT results were analyzed, and receiver operating characteristic (ROC) analysis was performed to determine optimal diagnostic cutoffs. Among participants, 106 (86.9%) were SPT-positive for Der p and 80 (65.6%) for Der f. Using the conventional screening threshold (sIgE\u2009\u2265\u20090.35 IU\/mL), 86 (70.5%) were positive for Der p and 60 (49.2%) for Der f. NPT positivity was observed in 88 (72.1%) patients for Der p and in 68 (55.7%) patients for Der f. ROC analysis identified higher cutoffs associated with improved specificity: \u22654.2\u00a0mm mean wheal diameter (MWD) for SPT and \u2265\u20091.10 IU\/mL for sIgE in Der p, and \u2265\u20093.75\u00a0mm MWD and \u2265\u20090.50 IU\/mL for Der f. While the conventional sIgE threshold (\u2265\u20090.35 IU\/mL) remained a strong independent predictor of NPT positivity, the ROC-derived cutoffs demonstrated enhanced diagnostic precision. Our results suggest that although conventional thresholds remain appropriate for initial screening, the ROC-optimized values identified in this study provide greater diagnostic precision and may aid clinical decision-making when NPT is unavailable.<\/jats:p>","DOI":"10.1038\/s41598-026-44756-2","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T15:04:55Z","timestamp":1775833495000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Refining the diagnosis of house dust mite-induced allergic rhinitis: optimizing SPT and sIgE cutoff values as predictors of clinically relevant allergy"],"prefix":"10.1038","volume":"16","author":[{"given":"Lobna A.","family":"El-Korashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9400-7822","authenticated-orcid":false,"given":"Noha M.","family":"Hammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Gheith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman Mohamed Abdel Fattah","family":"Ouda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessma Hessin Mohamed","family":"Gandor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar A.","family":"Abdelsalam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Nagy","family":"Hadhoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2145-8817","authenticated-orcid":false,"given":"Doaa alhussein","family":"Abo-alella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"44756_CR1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s40629-022-00226-5","volume":"31","author":"S Vrtala","year":"2022","unstructured":"Vrtala, S. 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