(Figure 2E)
Four studies for sIgE-walnut [39, 45, 69, 156, 174] met inclusion criteria for meta-analyses showing a pooled sensitivity of 87% and 82% specificity. For Jug r 1 sensitivity has higher at 90% for a median cut-off 0.2 kUA/L[45, 66, 69] (Figure 2F). Four studies for sIgE-almond [89, 148, 156, 174] met inclusion criteria for meta-analyses, with a pooled sensitivity of 72% and 95% specificity at a median cut of 3.4 kUA/L. Hazelnut and walnut studies were heterogeneous regarding co-sensitizations, comorbidities, and age of subjects. Studies for cashew and almond were less heterogeneous than those for hazelnut and walnut.
For hazelnut, the maximum sensitivity was ≥ 90% using hazelnut-sIgE. The maximum specificity was ≥ 90% for hazelnut SPT and Cor a 14-sIgE. For cashew, maximum sensitivity was ≥ 90% and maximum specificity was ≥ 90% for SPT to cashew, sIgE to cashew and Ana o 3-sIgE. For walnut-sIgE, maximum specificity was ≥ 90% for Jug r 1. For almond, maximum sensitivity and specificity were ≥ 90% for almond-sIgE (Tables S5 and S6 ).