Background: 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: 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 Methods phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts.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: 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 a priori as being achieved if 70% or more of panel members rated a statement as "strongly agree" to "agree" after the second round. Based on feedback, 2 additional online voting rounds were conducted. Results: 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: 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.
WAO consensus on DEfinition of Food Allergy SEverity (DEFASE) / Arasi, Stefania; Nurmatov, Ulugbek; Dunn-Galvin, Audrey; Roberts, Graham; Turner, Paul J; Shinder, Sayantani B; Gupta, Ruchi; Eigenmann, Philippe; Nowak-Wegrzyn, Anna; Ansotegui, Ignacio J; Rivas, Montserrat Fernandez; Petrou, Stavros; Tanno, Luciana K; Vazquez-Ortiz, Marta; Vickery, Brian; Wong, Gary; Alvaro-Lozano, Montserrat; Asaria, Miqdad; Begin, Philippe; Bozzola, Martin; Boyle, Robert; Brough, Helen; Cardona, Victoria; Chinthrajah, R Sharon; Cianferoni, Antonella; Deschildre, Antoine; Fleischer, David; Gazzani, Flavio; Gerdts, Jennifer; Giannetti, Marilena; Greenhawt, Matthew; Guzmán, Maria Antonieta; Hossny, Elham; Kauppi, Paula; Jones, Carla; Lucidi, Francesco; Monge Ortega, Olga Patricia; Munblit, Daniel; Muraro, Antonella; Pajno, Giovanni; Podestà, Marcia; Rodriguez Del Rio, Pablo; Said, Maria; Santos, Alexandra; Shaker, Marcus; Szajewska, Hania; Venter, Carina; Warren, Cristopher; Winders, Tonya; Ebisawa, Motohiro; Fiocchi, Alessandro. - In: THE WORLD ALLERGY ORGANIZATION JOURNAL. - ISSN 1939-4551. - 16:3(2023), p. 100753. [10.1016/j.waojou.2023.100753]
WAO consensus on DEfinition of Food Allergy SEverity (DEFASE)
Bozzola, Martin;Lucidi, Francesco;
2023
Abstract
Background: 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: 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: 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: 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 a priori as being achieved if 70% or more of panel members rated a statement as "strongly agree" to "agree" after the second round. Based on feedback, 2 additional online voting rounds were conducted. Results: 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: 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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
