{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:57:17Z","timestamp":1781067437056,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005888","name":"Uniwersytet Medyczny w Lodzi","doi-asserted-by":"publisher","award":["503\/1\u2010064\u201001\/503\u201011\u2010001"],"award-info":[{"award-number":["503\/1\u2010064\u201001\/503\u201011\u2010001"]}],"id":[{"id":"10.13039\/501100005888","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BP180 and BP230 enzyme\u2010linked immunosorbent assays (ELISA) are widely used to support the diagnosis of bullous pemphigoid (BP), yet published sensitivity and specificity vary. We assessed whether methodological limitations and incomplete reporting may contribute to optimistic \u201cheadline\u201d accuracy estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a meta\u2010epidemiological methodological study of 18 published diagnostic accuracy studies (2004\u20132025) contributing 42 ELISA index tests (23 BP180, 19 BP230). Risk of bias was assessed with QUADAS\u20102 and reporting quality with a 16\u2010item STARD\u2010based checklist. We summarized sensitivity and specificity and compared estimates by patient\u2010selection risk (low vs. high\/unclear) and cut\u2010off type (manufacturer\/prespecified vs. post hoc). No new pooled meta\u2010analysis of diagnostic accuracy was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patient selection was at high risk of bias in 15\/18 studies (83%), and no study was judged low risk in the QUADAS\u20102 index test domain. Key safeguards were rarely reported: blinding 6\/42 tests (14%), participant flow diagram\u00a00\/42 (0%), and indeterminate\/missing results 14\/42 (33%). Median sensitivity\/specificity were 0.82\/0.94 (BP180) and 0.58\/0.98 (BP230). BP180 sensitivity tended to be lower in low\u2010risk versus high\/unclear\u2010risk patient\u2010selection studies (0.69 vs. 0.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093 low\u2010risk studies).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Published ELISA accuracy\u2014especially sensitivity\u2014may be overestimated; in practice, a negative ELISA should not be used to rule out BP when clinical suspicion is high.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/ijd70524-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70524","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:03:36Z","timestamp":1781064216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Bias and Reporting Quality in\n                    <scp>BP180<\/scp>\n                    \/\n                    <scp>BP230 ELISA<\/scp>\n                    Diagnostic Studies of Bullous Pemphigoid: A Meta\u2010Epidemiological Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8013-9054","authenticated-orcid":false,"given":"Monika","family":"Grochowska\u2010Rak","sequence":"first","affiliation":[{"name":"Department of Dermatology John Paul II Provincial Hospital  Belchatow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kulig","sequence":"additional","affiliation":[{"name":"Department of Dermatology John Paul II Provincial Hospital  Belchatow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arleta","family":"Grabowska","sequence":"additional","affiliation":[{"name":"Department of Dermatology John Paul II Provincial Hospital  Belchatow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violetta","family":"Karli\u0144ska\u2010Jonkisz","sequence":"additional","affiliation":[{"name":"Department of Dermatology John Paul II Provincial Hospital  Belchatow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Racisz","sequence":"additional","affiliation":[{"name":"Department of Dermatology John Paul II Provincial Hospital  Belchatow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Czop","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Medical University of Lublin  Lublin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendri H.","family":"Pas","sequence":"additional","affiliation":[{"name":"Center for Blistering Diseases, Department of Dermatology University Medical Center Groningen, University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Lesiak","sequence":"additional","affiliation":[{"name":"Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Dermatological Oncology Medical University of Lodz  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Barasi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Pediatric Dermatology and Oncology Medical University of Lodz  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Matych","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Pediatric Dermatology and Oncology Medical University of Lodz  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Narbutt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Pediatric Dermatology and Oncology Medical University of Lodz  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00220"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806\u20104841.20199007"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.357"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13717"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2011.03.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.07.009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20106632.2009.04630.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.70136"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.7326\/0003-4819-149-12-200812160-00008","article-title":"Systematic Reviews of Diagnostic Test Accuracy","volume":"149","author":"Leeflang M. M. G.","year":"2008","journal-title":"Annals of Internal Medicine"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.282.11.1061","article-title":"Empirical Evidence of Design\u2010Related Bias in Studies of Diagnostic Tests","volume":"282","author":"Lijmer J. G.","year":"1999","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1503\/cmaj.050090","article-title":"Evidence of Bias and Variation in Diagnostic Accuracy Studies","volume":"174","author":"Rutjes A. W. S.","year":"2006","journal-title":"Canadian Medical Association Journal"},{"key":"e_1_2_9_13_1","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy","author":"Macaskill P.","year":"2013"},{"key":"e_1_2_9_14_1","article-title":"STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies","volume":"351","author":"Bossuyt P. M.","year":"2015","journal-title":"BMJ (Clinical Research Edition)"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012799","article-title":"STARD 2015 Guidelines for Reporting Diagnostic Accuracy Studies: Explanation and Elaboration","volume":"6","author":"Cohen J. F.","year":"2016","journal-title":"BMJ Open"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS\u20102: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies","volume":"155","author":"Whiting P. F.","year":"2011","journal-title":"Annals of Internal Medicine"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjidi.2025.100415"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1016\/j.pathol.2023.12.372","article-title":"Evaluation of the Dermatology Profile ELISA Assay (IgG) for Detection of Six Autoantibodies in Autoimmune Blistering Disease Cohort","volume":"56","author":"Kakar F.","year":"2024","journal-title":"Pathology"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0022\u2010202X.2004.22603.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2005.11.002"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.21"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339776"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.5021\/ad.2012.24.1.45"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378\u20106323.102364"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2012.05.007"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.12510"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403\u2010016\u20101631\u20101"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555\u20102223"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.11.002"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2017.3166"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13591"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.12932\/AP\u2010231118\u20100446"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2018.4390"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.05.014"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000238386.41398.30"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/eb\u20102013\u2010101637"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2020.40.3.245"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010140\u20103\u2010200402030\u201000010"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2016.12.007"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1576635"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70524","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.70524","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:03:44Z","timestamp":1781064224000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.70524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,9]]},"references-count":39,"alternative-id":["10.1111\/ijd.70524"],"URL":"https:\/\/doi.org\/10.1111\/ijd.70524","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,9]]},"assertion":[{"value":"2026-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijd.70524"}}