학술논문
WAO consensus on DEfinition of Food Allergy SEverity (DEFASE)
Document Type
article
Author
Stefania Arasi, MD, PhD, MSc; Ulugbek Nurmatov, MD; Audrey Dunn-Galvin, PhD; Graham Roberts, DM; Paul J. Turner, FRCPCH, PhD; Sayantani B. Shinder, MD, PhD; Ruchi Gupta, MD, MPh; Philippe Eigenmann, MD; Anna Nowak-Wegrzyn, MD, PhD; Ignacio J. Ansotegui, MD, PhD; Montserrat Fernandez Rivas, MD; Stavros Petrou, PhD; Luciana K. Tanno, MD, PhD; Marta Vazquez-Ortiz, MD, PhD; Brian Vickery, MD, PhD; Gary Wong, MD, FRCPC; Montserrat Alvaro-Lozano, MD, PhD; Miqdad Asaria, PhD; Philippe Begin, MD, MSc; Martin Bozzola, MD; Robert Boyle, MD; Helen Brough, MD, PhD; Victoria Cardona, MD, PhD; R. Sharon Chinthrajah, MD, PhD; Antonella Cianferoni, MD; Antoine Deschildre, MD; David Fleischer, MD; Flavio Gazzani, PhD; Jennifer Gerdts; Marilena Giannetti, PhD; Matthew Greenhawt, MD, MBA, MSc; Maria Antonieta Guzmán, MD; Elham Hossny, MD, PhD, FAAAAI; Paula Kauppi, MD; Carla Jones; Francesco Lucidi, PhD; Olga Patricia Monge Ortega, MD, PhD; Daniel Munblit, MD, PhD; Antonella Muraro, MD; Giovanni Pajno, MD; Marcia Podestà; Pablo Rodriguez del Rio, MD, PhD; Maria Said; Alexandra Santos, MD, MSc, MRCPCH, PGCAP, FHEA, PhD; Marcus Shaker, MD; Hania Szajewska, MD, PhD; Carina Venter, PhD; Cristopher Warren, PhD; Tonya Winders; Motohiro Ebisawa, MD, PhD; Alessandro Fiocchi, MD
Source
World Allergy Organization Journal, Vol 16, Iss 3, Pp 100753- (2023)
Subject
Language
English
ISSN
1939-4551
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 Methods: Phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts.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.