Mobile App-Based Lifestyle Coaching Intervention for Patients With Nonalcoholic Fatty Liver Disease: Randomized Controlled Trial.

BACKGROUND: Lifestyle modification in patients with nonalcoholic fatty liver disease (NAFLD) is key to improving health outcomes. Mobile health technologies may offer potential effective and efficient health care support to facilitate self-management. OBJECTIVE: This study aims to develop a lifestyle coaching intervention using a mobile app for patients with NAFLD and evaluate physiological and psychological health outcomes for 6 months. METHODS: This study was a randomized controlled trial. The personalized lifestyle coaching intervention using a mobile app was developed through established guidelines and literature reviews. This intervention consisted of information on NAFLD management, diet and physical activity self-monitoring, and coaching sessions based on patient records and SMS text messages. A total of 102 individuals were enrolled in the study and randomly assigned to the intervention group (n=48) or the control group (n=54). The outcomes were improvements in physiological (weight, liver fat score, aspartate aminotransferase, alanine transferase, and gamma-glutamyl transferase) and clinical outcomes (self-management, NAFLD self-management knowledge, self-efficacy, fatigue, depression, and quality of life). Data were analyzed using descriptive analysis and a linear mixed model to test the effects of the intervention. RESULTS: All participants completed the study. The mean age of the participants was 48.9 (SD 13.74) years, 38.2% (39/102) were female participants, and 65.7% (67/102) were married. There were no differences in baseline demographic and clinical data between the intervention and control groups. Changes from baseline to 6 months were significant only within the intervention group for weight (P<.001), liver fat score (P=.01), aspartate aminotransferase (P=.03), alanine transferase (P=.002), gamma-glutamyl transferase (P=.04), self-management (P<.001), fatigue (P=.005), depression (P=.003), and quality of life (P<.001). The differences between the 2 groups for the changes over the 6 months were significant in self-management (P=.004), self-management knowledge (P=.04), fatigue (P=.004), depression (P=.04), and quality of life (P=.01). However, the intervention-by-time interaction was significantly effective only for self-management (P=.006) and fatigue (P=.02). CONCLUSIONS: Nonpharmacological interventions using a mobile app may be effective in improving the physiological and psychological health outcomes of patients with NAFLD. TRIAL REGISTRATION: Clinical Research Information Service KCT0005549; http://tinyurl.com/y2zb6usy.

Correction: Mobile App-Based Lifestyle Coaching Intervention for Patients With Nonalcoholic Fatty Liver Disease: Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/49839.].

Low-Dose Aspirin for Primary Prevention of Cardiovascular Events Comparing East Asians With Westerners: A Meta-Analysis.

Background: East Asians have shown different risk profiles for both thrombophilia and bleeding than Western counterparts. Objectives: The authors sought to evaluate the effect of low-dose aspirin for primary prevention between these populations. Methods: We searched randomized clinical trials (RCTs) for intervention with low-dose aspirin (≤100 mg once daily) in participants without symptomatic cardiovascular disease until December 31, 2021. The number of events between the arms was extracted for analysis. Pooled risk ratios (RRs) and risk differences (RDs) were analyzed in each population. Outcomes included a major adverse cardiovascular event (MACE), cardiovascular death, myocardial infarction, stroke, and major bleeding (intracranial hemorrhage and major gastrointestinal bleeding). Results: Two RCTs included 17,003 East Asians, and 9 RCTs had 117,467 Western participants. Aspirin treatment showed a similar effect in reducing the MACE rate (RR of East Asians: 0.87; 95% CI: 0.71-1.05; RR of Westerners: 0.90; 95% CI: 0.85-0.95) (Pinteraction = 0.721). In contrast, the risk of major bleeding during aspirin vs control was greater in the East Asian population (RR: 2.48; 95% CI: 1.86-3.30) compared with the Western population (RR: 1.45; 95% CI: 1.26-1.66) (Pinteraction = 0.001), which was driven by more frequent gastrointestinal bleeding (RR of East Asians: 3.29; 95% CI: 2.26-4.80 vs RR of Westerners: 1.56; 95% CI: 1.29-1.88) (Pinteraction < 0.001). The net RDs (RD of MACE plus RD of major bleeding) were 8.04 and 0.72 per 1,000 persons in East Asian and Western participants, indicating 124 and 1,389 of the net number needed to harm, respectively. Conclusions: Low-dose aspirin for primary prevention in East Asians must be cautiously prescribed because of the increased risk of major bleeding relative to Western counterparts.

Quantitative Network Comparisons of REM Sleep Without Atonia Across the α-Synucleinopathy Spectrum: A Systematic Review.

Purpose: Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by REM sleep without atonia (RWA) and is regarded as the prodromal stage of α-synucleinopathies, such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). RWA is also associated with neurodegeneration driven by α-synucleinopathy. However, the level of RWA across the α-synucleinopathy spectrum remains elusive. We aimed to rate the percentage of RWA across the α-synucleinopathy spectrum, encompassing prodromal and overt phenotypes. Methods: A systematic search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases. We included cohort, cross-sectional, and case-control studies comparing the RWA percentage during REM sleep evaluated by tonic chin activity (RWA%-T) or by phasic chin activity (RWA%-P) across the α-synucleinopathy spectrum. Bayesian network meta-analysis was used to combine both direct and indirect evidence regarding the group differences in the RWA%-T and RWA%-P. The surface under the cumulative ranking curve was used to estimate the ranked probability. Results: Fifteen articles met the inclusion criteria. The investigations included 204 iRBD, 295 PD with RBD (PDwtRBD), 187 PD without RBD (PDwoRBD), 42 MSAwtRBD, 9 DLBwtRBD patients, and 246 controls. MSAwtRBD ranked first in RWA%-T, whereas iRBD ranked first in RWA%-P. RWA% in PDwoRBD patients was comparable to that in the controls and was lower than that in PDwtRBD patients. Conclusion: Overt phenotypes such as MSAwtRBD and PDwtRBD ranked high in RWA%-T, whereas iRBD, a prodromal type, ranked highest in RWA%-P. Taken together, our data suggest that the percentage of neurodegeneration in RBD patients may be associated with RWA%-T rather than RWA%-P. Prospero Registration Number: CRD42021276445.

Felt stigma proportion in people living with epilepsy: A systematic review.

PURPOSE: Numerous inventories to identify felt stigma (FS) in people living with epilepsy (PLWE) have been developed. Past studies have mainly focused on the relationship between FS scores and clinical factors, making it challenging to delineate FS proportions and compare FS between groups. We aimed to integrate FS proportions in PLWE and compare them by continent. METHODS: We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and Scopus. Among the identified studies, we chose the ones providing an FS proportion measured by Jacoby's Stigma Scale (JSS) and its revised version (JSS-R) in PLWE. We applied the random-effects model. RESULTS: A total of 63 datasets from 47 studies were included. There were 29,924 PLWE, with 14,323 of them experiencing FS. The overall FS proportion was 48.4%. Of these datasets, 51 used JSS, and 12 used JSS-R. The FS proportions were 44.9% for the former and 62.1% for the latter, with significant heterogeneity. In the intercontinental comparison with 51 datasets employing JSS, the difference in FS proportions was insignificant: 51.2% in Africa, 47.2% in Europe, 35.4% in Asia, and 28.8% in the Middle East. Furthermore, the meta-regression revealed that the year of each primary study did not influence the FS proportion. CONCLUSION: Among PLWE, FS proportions depended on the choice of a measurement tool. When measured using JSS, the FS proportion was 44.9%, while it was 62.1% when evaluated with JSS-R. Even though the FS proportions were integrated differently, no substantial differences were observed between continents.

The Effectiveness of eHealth Interventions on Lifestyle Modification in Patients With Nonalcoholic Fatty Liver Disease: Systematic Review and Meta-analysis.

BACKGROUND: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in parallel with the epidemic of obesity and metabolic syndrome. Lifestyle modification is a crucial strategy for the treatment of NAFLD, which can lead to a reduction in liver fat with concomitant weight loss. The use of eHealth technologies is an effective approach to improve health outcomes in patients as they do not have any time and space limitations. OBJECTIVE: This study aimed to evaluate published eHealth intervention studies for the improvement of lifestyle modifications among patients with NAFLD and to provide recommendations for future studies. METHODS: We conducted a systematic review and meta-analysis. Five electronic databases (PubMed, Cochrane Central, CINAHL, Embase, and Web of Science) were searched for studies reporting the effect of lifestyle modification intervention using eHealth in patients with NAFLD published from inception to November 3, 2022. Study selection, data extraction, and quality assessment were performed by 3 researchers independently. The quality of included studies was assessed using the Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Nonrandomized Studies. RESULTS: In total, 2688 records were identified, and 41 full-text articles were assessed. Seven studies were included in the systematic review. The participants of all interventions were 1257 individuals with NAFLD, and the mean age ranged from 38.3 to 57.9 years. The duration of the interventions was 3-24 months, and all interventions were categorized into 3 types: internet-based computers, telephones, and mobile apps. Of these, 4 studies were randomized controlled trials and were included in the meta-analysis: 3 studies for body weight and BMI and 4 studies for alanine aminotransferase (ALT) and aspartate aminotransferase (AST). According to the meta-analysis, clear improvements in BMI (P=.02; 95% CI -1.01 to -0.10), AST (P=.02; 95% CI -1.22 to -0.13), and ALT (P=.01; 95% CI -1.28 to -0.15) were observed in the eHealth intervention as compared with the control groups. CONCLUSIONS: Lifestyle modification interventions using eHealth technologies are significantly effective for BMI, AST, and ALT in patients with NAFLD. Future research should conduct interventions with larger sample sizes and evaluate whether these interventions have sustained benefits, and how we can make these eHealth methods most effective on a large scale.

Impact of the Occurrence While Sleeping of First Unprovoked Seizure on Seizure Recurrence: A Systematic Review.

BACKGROUND AND PURPOSE: The impact of the occurrence while sleeping of first unprovoked seizure (FUS) on seizure recurrence in people with FUS is currently unclear. This uncertainty makes it challenging for physicians to determine whether to apply antiseizure medications (ASMs) to people with FUS while sleeping (FUS-S). This study aimed to determine the impact of the occurrence while sleeping of FUS. METHODS: We searched the MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus electronic databases. Among retrieved studies, we selected those that provided information on the number of people with FUS, and relapsed people among these in each instance of FUS-S and FUS when waking (FUS-W). We used a random-effects model for meta-analyses. RESULTS: Of the 3,582 identified studies, 13 were eligible for systematic review. Seven of these 13 studies were deemed adequate for inclusion in a meta-analysis since they provided information at the time point of 2 years follow-up after FUS. The seven studies were of high quality regarding their risk of bias. When combining these 7 studies, the total sample comprised 1,659 people, of which 626 had FUS-S and 1,033 had FUS-W. The relative risk of seizure recurrence between FUS-S and FUS-W was 1.627. The seizure recurrence rates (SRRs) were 59.8% and 36.5% in the FUS-S and FUS-W groups, respectively. CONCLUSIONS: We verified that the SRR was higher among people with FUS-S than FUS-W. After 2 years of follow-up, the SRR in people with FUS-S was about 60%. It is preferable to initiate an ASM for people with FUS-S. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42021266191.

Real-time online point-of-view filming education for teaching clinical skills to medical students.

PURPOSE: This study aimed to measure the educational satisfaction with and effectiveness of real-time online point-of-view filming (POVF) clinical skills education in medical students. METHODS: Medical students participated in a 120-minute clinical skills education session. The session consisted of emergency procedures, wound management, and vascular access. The authors provided real-time online POVF using a smartphone. A questionnaire survey was issued to the students after the class, and their satisfaction with education, educational environment, and effectiveness were analyzed. RESULTS: Responses about satisfaction with POVF education were very positive in all grades. However, approximately half of the students were satisfied with the smoothness of listening to a lecture and the video quality. More than half of the students responded positively to the question about educational effectiveness. CONCLUSION: In these times of non-classroom teaching brought on by the coronavirus disease 2019 (COVID-19) pandemic, POVF clinical skills education is likely to be a very useful educational tool. If disadvantages such as insufficient feedback or environmental problems can be addressed, it could serve as an alternative method of clinical skills education even after the COVID-19 pandemic.

Comparison of rapid eye movement without atonia quantification methods to diagnose rapid eye movement sleep behavior disorder: a systematic review.

STUDY OBJECTIVES: Rapid eye movement (REM) sleep without atonia (RWA) is essential for diagnosing REM sleep behavior disorder (RBD). Manual and automatic quantifications of RWA that use different criteria have been validated. This study compared the RWA quantification methods for diagnosing RBD. METHODS: The PubMed, EMBASE, Web of Science, and Cochrane Library databases were systemically searched for studies published from inception to December 2021. The inclusion criteria were cohort, cross-sectional, and case-control studies assessing the sensitivity and specificity of RWA quantification methods. Pooled estimates of the sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were determined. Risk of bias and certainty of evidence was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool and the Grading of Recommendations, Assessment, Development, and Evaluations framework, respectively. RESULTS: Fourteen articles including 402 patients with RBD met the inclusion criteria. Manual methods evaluating any chin and phasic flexor digitorum superficialis (FDS) activity had the highest DOR (138.8, 95% CI = 21.8% to 881.7%) and AUC (0.9686). The automatic REM atonia index (RAI) showed similar or higher sensitivity (89.1%, 95% CI = 84.6% to 92.7%) but a lower specificity (73.5%), DOR (43.1), and AUC (0.9369) than the manual techniques. CONCLUSIONS: In this meta-analysis, manual RWA quantification that employed chin or phasic FDS activity had the best RBD diagnostic performance. The automatic RAI method may be useful for screening patients with RBD. The results should be interpreted carefully because of the high risk of bias in patient selection and significant heterogeneity among the studies. PROSPERO REGISTRATION NUMBER: CRD42021276445.

Reflex and Spontaneous Movements in Pediatric Patients with Brain Death.

BACKGROUND: Reflex and spontaneous movements are not uncommon in brain death patients. However, most studies have been conducted in adults, while reports in infants and children are rare. Thus, we aimed to evaluate the frequency and characteristics of these movements in pediatric patients declared as brain death. METHODS: Records of pediatric patients who were diagnosed as brain death from 15 hospitals in the Yeongnam region, South Korea, between January 2013 and September 2016 were analyzed. All body movements in patients who met the criteria for brain death as established by the Korea Medical Association were assessed by medical doctors and trained organ transplant coordinators. The frequency and characteristics of these movements were identified. Additionally, the demographic and clinical factors of the brain death patients with and without these movements were compared. RESULTS: A total of 31 patients who met the criteria for brain death were enrolled. Seven patients (22.6%) showed either reflex or spontaneous movements; six of them (85.7%) showed reflex movements only, and one patient (14.3%) showed both types of movements. The most common types of reflex movements were the flexor/extensor plantar response and isolated finger jerk. Four of seven patients (57.1%) showed a single movement pattern, while three (42.9%) showed two different movement patterns. CONCLUSION: It is essential for physicians who perform pediatric brain death examinations to recognize the frequency and characteristics of reflex and spontaneous movements, and this article may help in the accurate and prompt diagnosis of brain death.

Review of washing machine-related deaths in South Korea.

We reviewed data on washing machine-related deaths between 2008 and 2020 in South Korea to analyze the case characteristics, manners of death, and causes of death. Washing machine-related deaths are very rare, and only 23 incidents were identified over the study period. Of these cases, 19 (82.6%) were related to general pulsator-type top load washing machines; the other 4 (17.4%) were related to front-load washing machines. The pulsator-type top load washing machine-related deaths occurred in people aged between 40 and 93 years (mean age, 68 years), including 9 men (47.4%) and 10 women (52.6%). The manners of death among the incidents were suicide in 12 cases (63.2%), accident in 6 cases (31.6%), and unknown in 1 case (5.3%). A Medline search of the English literature currently does not yield results for washing machine-related suicidal deaths in adults. Of the 12 suicide cases, 4 were autopsied; suicidal death was determined by postmortem investigation or based on suicide notes. Washing machine-related suicidal deaths are presumed to have characteristics similar to those of bathtub suicidal deaths. The front-load washing machine-related deaths involved boys aged between 6 and 8 years, and all cases were concluded as accidents. The cause of death was hypoxia resulting from the children being accidentally trapped inside the washing machine while playing. Greater attention to vulnerable groups, especially children and older adults, is required to reduce the rate of washing machine-related accidental or suicidal deaths.

Self-Management and Associated Factors among Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study.

Self-management is critical and essential for controlling non-alcoholic fatty liver disease, delaying progression, and preventing complications. However, information about the self-management characteristics of this population is scarce. This study explores the characteristics and self-management levels and the factors associated with self-management in patients with non-alcoholic fatty liver disease in Korea. A convenience sample of 150 patients diagnosed with non-alcoholic fatty liver disease was recruited from April to November 2019. Demographics and clinical findings were collected, and self-management, self-efficacy, fatigue, and depressive symptoms were assessed using questionnaires. Multiple linear regression analysis was performed to examine the factors associated with self-management. Self-management levels were moderate (Mean = 3.4, SD = 0.61). Self-management differed significantly by age, sex, marital status, occupation, and health education experience. Self-efficacy (ß = 0.074, p = 0.020) showed a significant association with self-management, which explained 25.0% of the variance after controlling for age, sex, marital status, health education experience, occupation, controlled attenuation parameter score, and body mass index. Self-efficacy is a critical determinant of self-management among patients with non-alcoholic fatty liver disease. The study findings could assist healthcare professionals in facilitating self-management compliance and developing multidisciplinary team-based interventions for sustainable self-management.

Online clinical skills education using a wearable action camera for medical students.

The purpose of this study is to analyze medical students' satisfaction and educational effectiveness after real-time online clinical skills education using a wearable action camera. One hundred eighteen third-year medical students participated in this study. The education program consisted of clinical skills (wound management and vascular access procedures) and a medical interview with a simulated patient. The author wore the head-mounted action camera throughout the class. A systematic questionnaire survey was issued to the students after the education program to analyze the educational satisfaction and effectiveness. This education program showed their high educational satisfaction. The online environment was also mostly positive except for some negative comments about video quality. In the educational satisfaction, though the comparative satisfaction with the face-to-face skill class was slightly lower, the rest of the questionnaire items also showed high relative satisfaction. Online video education using a wearable camera could be a good modality that can replace a face-to-face class when it is impossible to open the class.

Development and Pilot Testing of a Smartphone-Based Self-Care Program for Patients with Chronic Hepatitis B.

The purpose of this study is to develop a smartphone-based self-care program (Hep B Care®) for patients with the chronic hepatitis B virus (HBV). To pilot test the feasibility of Hep B Care®, 63 participants with chronic HBV were recruited from an outpatient clinic at S hospital, Seoul, South Korea (experimental group [EG]: n = 30, control group [CG]: n = 33) between February and July 2016. Hep B Care® was developed based on the theory of self-care whilst having a chronic illness. During the 12-week intervention period, the application: (1) provided information about the disease, medication, nutrition, and exercise; (2) encouraged taking medication and exercise using alarms; and (3) enabled the exchange of messages between healthcare providers and patients. Salivary cortisol, fatigue, depression, anxiety, knowledge of the HBV, quality of life, and medication adherence were all measured as outcomes. Cortisol levels were significantly increased, knowledge of the HBV was improved, and the mean anxiety score was significantly decreased in the EG. Thus, Hep B Care ® partially improved health outcomes in the EG. We recommend that large trials be conducted among patients with the HBV. The smartphone-based self-care program for providing education and coaching is effective for improving knowledge and reducing anxiety among patients with the HBV.

Cerebral current-source distribution associated with pain improvement by non-invasive painless signaling therapy in patients with failed back surgery syndrome.

BACKGROUND: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. METHODS: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. RESULTS: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. CONCLUSIONS: Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

Flipped learning: an alternative pedagogical approach in the untact age.

Flipped learning, abbreviated as "FL" is a new pedagogical approach that reverses the order of a typical lecture. It was developed to compensate for the shortcomings of a typical teaching method. Students learn by watching video clips before class and continue to learn through peer discussion in the classroom. The educational benefits of FL like student's positive attitude were revealed in the previous studies. FL can be a valuable alternative to the existing classes in the untact age of coronavirus disease 2019.

Development and initial validation of the nonalcoholic fatty liver disease self-management questionnaire.

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, and self-management is essential to improve health outcomes in this population. Despite the importance of self-management, there is no instrument to assess it in patients with NAFLD. The purpose of this study was to develop and validate an initial version of a self-management questionnaire for patients with NAFLD. This was a methodological and psychometric study conducted between April and November 2019. The NAFLD self-management questionnaire was developed after a theoretical and literature review and focus group interviews in three phases: (1) item generation, (2) item evaluation, and (3) psychometric evaluation. Participants (N = 155) were recruited from a hospital in Seoul, South Korea. Items were generated based on clinical NAFLD guidelines and the individual and family self-management theory. Construct validity was assessed using exploratory factor analysis. Six-factors were extracted from 22 items: lifestyle management, medical treatment compliance, management of medication and dietary supplements, alcohol consumption management, sleep management, and family support. These factors accounted for 67.4% of the total variance; each factor had an eigenvalue greater than 1, and Cronbach's alpha for the scale was 0.87. The NAFLD self-management questionnaire showed acceptable initial validity and reliability. The instrument can prove useful in the formulation of tailored interventions based on individual patients' care needs. Furthermore, it may be used as an indicator of health outcomes in this population.

The role of allergen-specific IgE in predicting allergic symptoms on dog and cat exposure among Korean pet exhibition participants.

BACKGROUND: The values of the skin prick test (SPT) and allergen-specific IgE (sIgE) measurement in predicting dog and cat allergies remain unclear. We aimed to evaluate the usefulness of SPT and sIgE measurement in predicting self-reported allergic symptoms during exposure to dogs and cats in Korean adults. METHODS: A total of 552 participants in a pet exhibition in Korea completed questionnaires regarding exposure to dog or cat and the development of allergic symptoms during exposure. Study participants also underwent SPT using 3 different commercially available reagents, and had their blood drawn for measurement of serum total IgE and dog/cat-dander-IgE using ImmunoCAP®. RESULTS: Measurement of sIgE for dog and cat dander allergens provided the highest positive and negative predictive values and sensitivity, but not specificity (58%, 87.2%, 67.9%, and 93.1% for allergic symptoms on dog exposure; 64.7%, 83.2%, 74.8%, and 88.9% for those on cat exposure, respectively), in predicting self-reported allergic symptoms on dog and cat exposure. The sIgE level consistently exhibited the highest area under the receiver operating characteristic curve (0.749 and 0.719 for allergic symptoms on dog and cat exposure, respectively). Careful interpretation of SPT and sIgE measurements maximized the positive and negative predictive values, sensitivity, and specificity for predicting allergic symptoms on dog exposure (71.4%, 87.3%, 75.3%, and 99.3%) and those on cat exposure (71.4%, 85.3%, 79.3%, and 98.9%). CONCLUSIONS: The measurement of dog and cat dander sIgE levels may be useful for the exclusion of allergic symptoms related to pet exposure. Collective interpretation of SPT and sIgE tests facilitates identification of allergic symptoms on dog or cat exposure, giving a better rule-in test result.