The Dutch diagnostic model for laboratory animal allergen sensitization was generalizable in Canadian apprentices

J Clin Epidemiol. 2009 May;62(5):542-9. doi: 10.1016/j.jclinepi.2008.06.020. Epub 2008 Dec 12.


Objective: To assess the transportability of an existing diagnostic questionnaire model for the sensitization to laboratory animal (LA) allergens.

Study design and setting: The model was externally validated in 414 Canadian animal health apprentices. Several approaches were used: (1) no adjustment; (2) recalibration of the intercept of the model; (3) re-estimation of the intercept and the regression coefficients of predictors; and (4) model revision, by excluding the existing predictor(s) and/or including new predictor(s). The bootstrapping procedure was done following the third and fourth methods. The calibration was assessed graphically and with the Hosmer-Lemeshow (HL) test. Discriminative properties were determined by the area under the receiver operating characteristic curve (ROC area).

Results: When applied without adjustment, the model's discriminative ability was adequate (ROC area was 0.74 vs. the original ROC area of 0.76); the calibration was poor (HL test P<0.001). The other methods yielded models with good calibration (P>0.10) and reasonable discrimination (ROC area ranged between 0.73 and 0.75). The refitted and revised model showed a good internal validity (correction factor from the bootstrapping procedure was more than 0.90).

Conclusion: Once updated, the diagnostic model is valid and can be applied with reasonable performance in an animal health apprentice setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Allergens / immunology*
  • Animal Technicians*
  • Animals
  • Animals, Laboratory
  • Calibration
  • Canada
  • Cohort Studies
  • Female
  • Guinea Pigs
  • Humans
  • Immunization
  • Male
  • Mice
  • Models, Biological
  • Netherlands
  • Occupational Diseases / diagnosis*
  • Occupational Diseases / immunology
  • Occupational Exposure*
  • ROC Curve
  • Rabbits
  • Rats
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Veterinarians*
  • Young Adult


  • Allergens