Are combinations of questions better than individual questions for detecting sensitization to mite allergen?

Previous studies have found that questions are considerably less sensitive for predicting sensitization to dust mites than to pollens or to household pets. We studied 1160 children with respiratory symptoms to find whether the sensitivity for predicting mite allergy could be increased by asking several rather than single questions. Parents accompanying the children were asked standardized validated questions. Of the four individual questions relevant to mites, the one with the highest sensitivity for predicting a positive skin prick test to this allergen was whether the symptoms were worse when the house was being swept, vacuumed or dusted (29.8%). If an affirmative answer to that question, or to any of the other three questions, was taken as predictive of sensitization, the sensitivity increased to 54.2%. However, requiring only a single affirmative answer to this combination of questions decreased the specificity. The sensitivity of the combination of questions was comparable to that of questions for predicting positive tests to tree pollens (56.4%), cats (56.4%), grass pollens (52.5%) and dogs (51.4%). We conclude that asking a combination of questions is an useful for indicating possible sensitization to dust mite as are questions for detecting sensitization to other common inhalant allergens.