WAO consensus on DEfinition of Food Allergy SEverity (DEFASE).

Consensus Definition Food allergy Severity e-Delphi study

Journal

The World Allergy Organization journal
ISSN: 1939-4551
Titre abrégé: World Allergy Organ J
Pays: United States
ID NLM: 101481283

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 15 09 2022
revised: 20 01 2023
accepted: 03 02 2023
entrez: 13 3 2023
pubmed: 14 3 2023
medline: 14 3 2023
Statut: epublish

Résumé

While several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole. To develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally. We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts. Based on our findings in Phase 1, we drafted statements for a two-round modified electronic Delphi (e-Delphi) survey. A purposefully selected multidisciplinary international expert panel on food allergy (n = 60) was identified and sent a structured questionnaire, including a set of statements on different domains of food allergy severity related to symptoms, health-related quality of life, and economic impact. Participants were asked to score their agreement on each statement on a 5-point Likert scale ranging from "strongly agree" to "strongly disagree". Median scores and percentage agreements were calculated. Consensus was defined We received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score. The DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.

Sections du résumé

Background UNASSIGNED
While several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole.
Aim UNASSIGNED
To develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally.
Methods Phase 1 UNASSIGNED
We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts.
Phase 2 UNASSIGNED
Based on our findings in Phase 1, we drafted statements for a two-round modified electronic Delphi (e-Delphi) survey. A purposefully selected multidisciplinary international expert panel on food allergy (n = 60) was identified and sent a structured questionnaire, including a set of statements on different domains of food allergy severity related to symptoms, health-related quality of life, and economic impact. Participants were asked to score their agreement on each statement on a 5-point Likert scale ranging from "strongly agree" to "strongly disagree". Median scores and percentage agreements were calculated. Consensus was defined
Results UNASSIGNED
We received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score.
Conclusions UNASSIGNED
The DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.

Identifiants

DOI: 10.1016/j.waojou.2023.100753 PMID: 36910595 PMC: PMC9996094
pubmed: 36910595
doi: 10.1016/j.waojou.2023.100753
pii: S1939-4551(23)00013-3
pmc: PMC9996094
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100753

Informations de copyright

© 2023 The Authors.

Références

J Allergy Clin Immunol Pract. 2020 Jan;8(1):75-90.e17
pubmed: 31950914
Front Immunol. 2018 Sep 21;9:2057
pubmed: 30298065
Allergy. 2020 Nov;75(11):2734-2752
pubmed: 32558994
J Allergy Clin Immunol. 2021 Jul;148(1):173-181
pubmed: 33476673
J Allergy Clin Immunol. 2021 Dec;148(6):1526-1532
pubmed: 34048855
World Allergy Organ J. 2016 Aug 09;9:24
pubmed: 27551327
Allergy. 2016 Feb;71(2):135-6
pubmed: 26381421
BMC Complement Med Ther. 2020 Jan 15;20(1):10
pubmed: 32020878
Allergy. 2022 May;77(5):1545-1558
pubmed: 34716996
J Allergy Clin Immunol. 2007 Apr;119(4):1018-9
pubmed: 17349682
Expert Rev Clin Immunol. 2018 Apr;14(4):307-314
pubmed: 29513116
Ann Allergy Asthma Immunol. 2015 Sep;115(3):217-223.e2
pubmed: 26112147
Clin Exp Allergy. 2012 Jan;42(1):30-7
pubmed: 22093016
Food Chem Toxicol. 2020 Dec;146:111831
pubmed: 33166672
Allergy. 2022 Feb;77(2):357-377
pubmed: 34343358
JAMA Netw Open. 2019 Jan 4;2(1):e185630
pubmed: 30646188
Allergy. 2014 Jan;69(1):62-75
pubmed: 24205824
BMJ Open. 2018 Sep 19;8(9):e024161
pubmed: 30232116
World Allergy Organ J. 2021 Mar 11;14(3):100503
pubmed: 33767801
Allergy. 2018 Sep;73(9):1792-1800
pubmed: 29331045
Allergy. 2016 Sep;71(9):1241-55
pubmed: 27138061
PLoS One. 2017 May 15;12(5):e0164849
pubmed: 28505187
Pediatr Allergy Immunol. 2022 Jan;33(1):e13695
pubmed: 34779046
Inform Prim Care. 2005;13(1):3-12
pubmed: 15949170
J Investig Allergol Clin Immunol. 2021 Apr 20;31(2):132-144
pubmed: 31638577
J Allergy Clin Immunol. 2021 Nov;148(5):1307-1315
pubmed: 33862009
Eur J Pediatr. 2019 Jan;178(1):69-75
pubmed: 30269250
Eur Respir J. 2014 Feb;43(2):343-73
pubmed: 24337046
Pediatrics. 2018 Dec;142(6):
pubmed: 30455345
Pediatr Allergy Immunol. 2010 Jun;21(4 Pt 1):603-11
pubmed: 20444154
Pediatrics. 2003 Jun;111(6 Pt 3):1601-8
pubmed: 12777599
Int J Obes (Lond). 2019 Dec;43(12):2573-2586
pubmed: 30655580
Allergy. 2022 Sep;77(9):2634-2652
pubmed: 35441718
J Allergy Clin Immunol. 2004 Aug;114(2):371-6
pubmed: 15316518
J Allergy Clin Immunol. 2020 Jan;145(1):70-80.e3
pubmed: 31627910
J Adv Nurs. 2000 Oct;32(4):1008-15
pubmed: 11095242
Pediatr Allergy Immunol. 2022 Jan;33(1):e13692
pubmed: 34724234
J Allergy Clin Immunol. 2020 Apr;145(4):1082-1123
pubmed: 32001253
Clin Transl Allergy. 2016 Sep 30;6:37
pubmed: 27733903
Allergy Asthma Proc. 2017 Mar 1;38(2):88-91
pubmed: 28234046
J Allergy Clin Immunol. 2022 Jun;149(6):2166-2170.e1
pubmed: 35026206
J Am Acad Dermatol. 2014 Feb;70(2):338-51
pubmed: 24290431
World Allergy Organ J. 2020 Oct 30;13(10):100472
pubmed: 33204386

Auteurs

Stefania Arasi (S)

Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Ulugbek Nurmatov (U)

Division of Population Medicine, School of Medicine, Cardiff University, Wales, UK.

Audrey Dunn-Galvin (A)

Applied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland.

Graham Roberts (G)

Faculty of Medicine, University of Southampton, Southampton, UK.
The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Paul J Turner (PJ)

National Heart & Lung Institute, Imperial College London, London, UK.

Sayantani B Shinder (SB)

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Stanford, CA, USA.

Ruchi Gupta (R)

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

Philippe Eigenmann (P)

Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland.

Anna Nowak-Wegrzyn (A)

Allergy and Immunology, Department of Pediatrics, New York University School of Medicine, Langone Health, New York, NY, USA.
Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.

Ignacio J Ansotegui (IJ)

Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.

Montserrat Fernandez Rivas (MF)

Allergy Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain.

Stavros Petrou (S)

Nuffield Department of Primary Care Health Sciences, University of Oxford.
Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, England, UK.

Luciana K Tanno (LK)

Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, France.
Desbrest Institute of Epidemiology and Public Health, UA-11, INSERM University of Montpellier, France.
WHO Collaborating Centre on Scientific Classification Support, Montpellier, France.

Marta Vazquez-Ortiz (M)

Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom.

Brian Vickery (B)

Department of Pediatrics, Emory University, Atlanta, GA, USA.

Gary Wong (G)

Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.

Montserrat Alvaro-Lozano (M)

Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Deu, Barcelona, Spain.
Institut de Recerca Sant Joan de Deu, Barcelona, Spain.
Universitat de Barcelona, Spain.

Miqdad Asaria (M)

Department of Health Policy, London School of Economics and Political Science, UK.

Philippe Begin (P)

Allergy, immunology and Rheumatology Division, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada.
Allergy and Clinical immunology Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal, QC, Canada.

Martin Bozzola (M)

Hospital Britanico de Buenos Aires Buenos Aires, Argentina.

Robert Boyle (R)

National Heart and Lung Institute, Imperial College London, UK.

Helen Brough (H)

Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital, London, UK.
Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.

Victoria Cardona (V)

Allergy Section, Department of Internal Medicine, Hospital Vall D'Hebron, Barcelona, Spain.
ARADyAL Research Network, Spain.

R Sharon Chinthrajah (RS)

Sean N Parker Center for Allergy and Asthma Research, Stanford University.

Antonella Cianferoni (A)

The Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, PA, United States.

Antoine Deschildre (A)

CHU Lille, Univ Lille, Pediatric Allergy and Pulmonology Unit, Hôpital Jeanne de Flandre, 59000 Lille, France.
Section of Pediatric Allergy & Immunology, Children's Hospital Colorado, USA.

David Fleischer (D)

University of Colorado School of Medicine, USA.

Flavio Gazzani (F)

Departement of Economics and Law, University of Rome La Sapienza, Italy.

Jennifer Gerdts (J)

Executive Director, Food Allergy Canada, Toronto, Ontario, Canada.

Marilena Giannetti (M)

Departement of Economics and Law, University of Rome La Sapienza, Italy.

Matthew Greenhawt (M)

Section of Allergy and Immunology, Children's Hospital Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.

Maria Antonieta Guzmán (MA)

Immunology and Allergy Service, Clinical Hospital University of Chile, Santiago, Chile.

Elham Hossny (E)

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.

Paula Kauppi (P)

University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Carla Jones (C)

Chief Executive of Patient Organisation, Allergy UK, London, UK.

Francesco Lucidi (F)

Allergology Unit of the San Juan de Dios Hospital, San José, Costa Rica.

Olga Patricia Monge Ortega (OP)

Departement of Economics and Law, University of Rome La Sapienza, Italy.

Daniel Munblit (D)

Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
Research and Clinical Center for Neuropsychiatry, Moscow, Russia.

Antonella Muraro (A)

Food Allergy Centre Department of Woman and Child Health Padua University Hospital, Padua Italy.

Giovanni Pajno (G)

Pediatric Unit- Policlinico Hospital, University of Messina, Messina, Italy.

Marcia Podestà (M)

Food Allergy Italia, Italy.

Pablo Rodriguez Del Rio (P)

Hospital Universitario Infantil Niño Jesus, Madrid, Spain.

Maria Said (M)

CEO Allergy & Anaphylaxis Australia, Sydney, Australia.

Alexandra Santos (A)

Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.

Marcus Shaker (M)

Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom.
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom.
Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
Dartmouth Geisel School of Medicine and Dartmouth-Hitchcock Medical Center, Lebanon.

Hania Szajewska (H)

Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.

Carina Venter (C)

Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.

Cristopher Warren (C)

Center for Food Allergy and Asthma Research, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, USA.

Tonya Winders (T)

Allergy & Asthma Network (AAN), President and CEO, Allergy and Asthma Network, Vienna, VA, USA.

Motohiro Ebisawa (M)

Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara Japan.

Alessandro Fiocchi (A)

Translational Research in Paediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Classifications MeSH