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 Methods phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts.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, S.; Nurmatov, U.; Dunn-Galvin, A.; Roberts, G.; Turner, P. J.; Shinder, S. B.; Gupta, R.; Eigenmann, P.; Nowak-Wegrzyn, A.; Ansotegui, I. J.; Rivas, M. F.; Petrou, S.; Tanno, L. K.; Vazquez-Ortiz, M.; Vickery, B.; Wong, G.; Alvaro-Lozano, M.; Asaria, M.; Begin, P.; Bozzola, M.; Boyle, R.; Brough, H.; Cardona, V.; Chinthrajah, R. S.; Cianferoni, A.; Deschildre, A.; Fleischer, D.; Gazzani, F.; Gerdts, J.; Giannetti, M.; Greenhawt, M.; Guzman, M. A.; Hossny, E.; Kauppi, P.; Jones, C.; Lucidi, F.; Monge Ortega, O. P.; Munblit, D.; Muraro, A.; Pajno, G.; Podesta, M.; Rodriguez del Rio, P.; Said, M.; Santos, A.; Shaker, M.; Szajewska, H.; Venter, C.; Warren, C.; Winders, T.; Ebisawa, M.; Fiocchi, A.. - 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)
Roberts G.;Gupta R.;Bozzola M.;Gazzani F.;Giannetti M.;Lucidi F.;Shaker M.;Warren C.;
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.| File | Dimensione | Formato | |
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