to the editor: I would like to commend the authors of “Vasomotor Rhinitis,”¹ in the September 15, 2005, issue of American Family Physician, for raising the issue of testing and its importance in accurately diagnosing allergic versus nonallergic rhinitis.

I believe the article¹ implies that skin testing is superior to immunoglobulin E (IgE) testing. Both of these tests have a place in diagnosing patients²; however, because allergic symptoms are highly associated with the production of IgE, a quantitative and objective diagnostic measure such as a specific IgE blood level is important to help accurately identify what is causing a patient's symptoms.³ Furthermore, the latest generation of specific IgE blood tests have been shown to be comparable to skin-prick testing in terms of sensitivity, specificity, and positive and negative predictive value.⁴ The newest generation assays are significantly more accurate than older radioallergosorbent testing methods.³

In a primary care setting, serum IgE testing using the newest and most accurate methodology is an excellent tool to assist family physicians in accurately diagnosing the cause of symptoms related to rhinitis.^5,6

editor's note: This letter was sent to the authors of “Vasomotor Rhinitis,” who declined to reply.