{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:33:30Z","timestamp":1787157210444,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002428","name":"Austrian Science Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002428","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Routine allergy diagnostic assessment relies on the patient's medical history, skin testing, and the detection of specific\n IgE<\/jats:styled-content>\n (\n sIgE<\/jats:styled-content>\n ) in the serum. In addition, molecular allergy diagnostics and the basophil activation test (\n BAT<\/jats:styled-content>\n ) can be used; however, these additional tests are costly and sometimes time\u2010consuming. Therefore, our objective was to identify the test with the highest sensitivity, determine the most effective combination of tests to enhance sensitivity, and develop a simple\n IgE<\/jats:styled-content>\n ratio to distinguish between bee and vespid venom allergy in cases of double positivity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed data from 190 bee venom\u2010allergic and 809 vespid venom\u2010allergic patients, along with 61 non\u2010allergic subjects. Sensitivity and specificity were assessed for\n sIgE<\/jats:styled-content>\n (\n ImmunoCAP<\/jats:styled-content>\n ), the intradermal test (\n IDT<\/jats:styled-content>\n ), and the\n BAT<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Applying a lower cut\u2010off of 0.1\n kU<\/jats:styled-content>\n \/L in patients with total\n IgE<\/jats:styled-content>\n <\u200930\n kU<\/jats:styled-content>\n \/L (while keeping the standard cut\u2010off of 0.35\n kU<\/jats:styled-content>\n \/L otherwise) increased sensitivity for\n sIgE<\/jats:styled-content>\n to bee venom from 85.7% to 94.6% and for vespid venom from 92.2% to 97.0%. The highest sensitivity (100%) was achieved by combining this\n sIgE<\/jats:styled-content>\n dual cut\u2010off approach with the intradermal test for bee venom allergy, while sensitivity for vespid venom allergy reached 98.5%. A vespid\/bee ratio \u2265\u20092.68 indicated vespid venom allergy with 59.3% sensitivity, while a bee\/vespid ratio \u2265\u20095.33 identified bee venom allergy with 50.6% sensitivity, both with 100% specificity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Conventional tests, such as\n sIgE<\/jats:styled-content>\n determination or intradermal testing, are usually sufficient. Combining both increases sensitivity, while additional tests provide no further benefit. Double\u2010positive findings may often be clarified using a simple\n sIgE<\/jats:styled-content>\n ratio, though sensitivity remains limited.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/all.70154","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:10:07Z","timestamp":1763017807000},"page":"2103-2110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Straightforward Algorithm for Diagnosing Hymenoptera Venom Allergy and Identifying the Relevant Venom for Immunotherapy"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-2070","authenticated-orcid":false,"given":"Lisa","family":"Arzt\u2010Gradwohl","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz 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University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Jungwirth","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Laipold","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Binder","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-121X","authenticated-orcid":false,"given":"Gunter J.","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz 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