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Development and validation of the food allergy severity score
M. Fernández-Rivas, I. Gómez García, A. Gonzalo-Fernández, M. Fuentes Ferrer, S. Dölle-Bierke, G. Marco-Martín, BK. Ballmer-Weber, R. Asero, S. Belohlavkova, K. Beyer, F. de Blay, M. Clausen, MR. Datema, R. Dubakiene, KEC. Grimshaw, K....
Jazyk angličtina Země Dánsko
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
34716996
DOI
10.1111/all.15165
Knihovny.cz E-zdroje
- MeSH
- alergeny MeSH
- lidé MeSH
- plocha pod křivkou MeSH
- potravinová alergie * diagnóza MeSH
- potraviny MeSH
- ROC křivka MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions. METHODS: Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best-Worst Scaling of 32 food reactions was calculated. RESULTS: oFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC-AUC]>0.80), classification (sensitivity 0.87-0.92, specificity 0.73-0.78), and calibration. Bootstrapping over ROC-AUC showed negligible biases (1.0 × 10-6 -1.23 × 10-3 ). In external validation, nFASS performed best with higher ROC-AUC. nFASS was strongly correlated (R 0.89) to best-worst scoring of 334 expert clinicians. CONCLUSION: FASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.
Allergy Clinic Copenhagen University Hospital at Herlev Gentofte Copenhagen Denmark
Allergy Department 2nd Pediatric Clinic University of Athens Athens Greece
Allergy Department Hospital Clínico San Carlos IdISSC ARADyAL Madrid Spain
Allergy Department Sotiria Chest Diseases Hospital Athens Greece
Allergy Division Chest Disease Department University Hospital of Strasbourg Strasbourg France
Allergy Dpt 2nd Pediatric clinic University of Athens Athens Greece
Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano Milan Italy
Children's Hospital and Department of Allergy Landspitali University Hospital Reykjavik Iceland
Clinic for Dermatology and Allergology Kantonsspital St Gallen St Gallen Switzerland
Clinic of Allergy and Asthma Medical University in Sofia Sofia Bulgaria
Clinical and Experimental Sciences Faculty of Medicine University of Southampton Southampton UK
Department of Allergy and Immunology Medical University of Lodz Lodz Poland
Department of Dermatology University Hospital Zurich Zurich Switzerland
Department of Dietetics Salford Royal NHS Foundation Trust Salford UK
Department of Pathophysiology and Allergy Research Medical University of Vienna Vienna Austria
Division of Infection Immunity and Respiratory Medicine University of Manchester Manchester UK
Grupo de Investigación en Alergia IdISSC Madrid Spain
Medical Faculty and Faculty Hospital Pilsen Pilsen Czech Republic
Medical Faculty Vilnius University Vilnius Lithuania
National Heart and Lung Institute Imperial College London London UK
Preventive Medicine Department Hospital Clínico San Carlos IdISSC Madrid Spain
Royal College of Surgeons in Ireland Children's Health Ireland at Temple Street Dublin Ireland
The David Hide Asthma and Allergy Research Centre St Mary's Hospital Isle of Wight UK
Citace poskytuje Crossref.org
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