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Development and validation of the Food Allergy Severity Score

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Fernández Rivas, Montserrat & Gómez García, Ismael & Gonzalo Fernández, Alejandro & Fuentes Ferrer, Manuel Enrique & Dölle- Bierke, Sabine & Marco- Martín, Guadalupe & Ballmer- Weber, Barbara K. & Asero, Riccardo .Development and validation of the Food Allergy Severity Score.

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Fernández Rivas, Montserrat & Gómez García, Ismael & Gonzalo Fernández, Alejandro & Fuentes Ferrer, Manuel Enrique & Dölle- Bierke, Sabine & Marco- Martín, Guadalupe & Ballmer- Weber, Barbara K. & Asero, Riccardo. Development and validation of the Food Allergy Severity Score.

https://hdl.handle.net/20.500.12080/26219
dc.contributor.author Fernández Rivas, Montserrat
dc.contributor.author Gómez García, Ismael
dc.contributor.author Gonzalo Fernández, Alejandro
dc.contributor.author Fuentes Ferrer, Manuel Enrique
dc.contributor.author Dölle- Bierke, Sabine
dc.contributor.author Marco- Martín, Guadalupe
dc.contributor.author Ballmer- Weber, Barbara K.
dc.contributor.author Asero, Riccardo
dc.date.accessioned 2021-11-23T13:55:42Z
dc.date.available 2021-11-23T13:55:42Z
dc.date.created 2021-11
dc.identifier.uri https://hdl.handle.net/20.500.12080/26219
dc.description.abstract 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. es_ES
dc.format application/pdf es_ES
dc.language eng es_ES
dc.rights CC-BY es_ES
dc.rights.uri http://creativecommons.org/licenses/by/4.0/deed.es es_ES
dc.subject allergic reactions, anaphylaxis, food allergy, score, severity es_ES
dc.title Development and validation of the Food Allergy Severity Score es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.rights.accessrights info:eu-repo/semantics/openAccess es_ES
dc.identifier.location N/A es_ES


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