st: SKIN PRICK TEST ANALYSIS

["Cornelius Nattey" <cornelius.nattey@nioh.nhls.ac.za>]

Dear All,
I am involve in a study "Longitudinal variability of skin prick test results to six common aeroallergens (CA) and three soybean allergens" 

The dependant variable is "changed status to CA" YES or NO. I.e. started off negative and became positive at some point in the survey to at least one CA or started off positive and became negative at some point in the survey to at least one CA = changes status YES; and if stayed the same throughout( ie negative  negative or positive positive)   

independent variables are: (1) the number of positive SPTs to CA at the initial test; (2) the size of the largest wheal at the initial test; and (3) the number of testings done.

What type of analysis can one do with this type of dataset?

Below are some considerations so please advice on what to do with the datasets:

The dataset with 110 people with 2 testings. At the initial testing we have +ve or -ve. At the second testing we have remained  +ve, remained  -ve, converted (-ve to +ve) or reverted.   (1) We will examine determinants of conversion. But only people who were initially negative can convert. Does this mean that we drop from this analysis the subjects who were initially positive (they have no chance of getting the outcome conversion)?
 I think we do not have to drop them as they still have the range of measurements across the independent variables and so can be used as a reference group for these variables. But I ask this question because for example in a study of the determinants of prostate cancer  you would not include subjects who have had a prostatectomy (for non-cancer reasons). (2) Same consideration for the analysis of reversion.   

The dataset with 4 testings does not have the same problem because conversion and reversion can occur along the time course of the study irrespective of initial status, and so all subjects are at risk of the outcome at some point (e.g. initially positive can revert and then convert so even if you are initially positive you have a risk of conversion at some point). I think.

Cornelius Nattey

Medical Scientist: Epidemiology and Surveillance
National Health Laboratory Service
National Institute for Occupational Health
Office: 011 712 6438
Fax: 086 604 1214
Cell: 079 631 5857
Email: cornelius.nattey@nioh.nhls.ac.za
www.nhls.ac.za  www.nioh.ac.za





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