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The urgent need for a harmonized severity scoring system for acute allergic reactions

机译:迫切需要一个急性过敏反应的协调严重程度评分系统

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摘要

Abstract The accurate assessment and communication of the severity of acute allergic reactions are important to patients, clinicians, researchers, the food industry, and public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach, and none has been validated. Their wide range of outcome formats has led to difficulties with interpretation and application. Therefore, there is a persisting need for an appropriately developed and validated severity scoring system for allergic reactions that work across the range of allergenic triggers and address the needs of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data‐driven method that is informed by clinical and patient experience and other stakeholders’ perspectives. We envisage two formats: (i) a numerical score giving a continuum from mild to severe reactions that are clinically meaningful and are useful for allergy healthcare professionals and researchers, and (ii) a three‐grade‐based ordinal format that is simple enough to be used and understood by other professionals and patients. Testing of reliability and validity of the new approach in a range of settings and populations will allow eventual implementation of a standardized scoring system in clinical studies and routine practice.
机译:摘要急性过敏反应严重程度的准确评估和沟通对患者,临床医生,研究人员,食品工业和公共卫生和监管机构都很重要。对不同利益相关者的严重程度与患者和临床医生对特定症状的意义具有不同的含义。已经产生了许多严重性评分系统,最关注暴露于有限的过敏原组后的反应严重程度。它们的形式是异构的,没有人使用了接受的发育方法,没有验证。他们广泛的结果格式导致了解释和应用的困难。因此,持续需要适当开发和验证的严重性评分系统,用于过敏反应,其在过敏反应范围内工作,并解决不同利益相关者群的需求。我们提出了一种新颖的发展方法,并基于通过临床和患者经验和其他利益相关者的观点来了解的数据驱动方法,验证急性过敏反应的协调评分系统。我们设想两种格式:(i)数值分数,从轻度到严重反应中的数值分数,临床上有意义,可用于过敏医疗保健专业人员和研究人员,以及(ii)一种足够简单的三级序数格式被其他专业人士和患者使用和理解。在一系列设置和人群中测试新方法的可靠性和有效性将使临床研究和常规实践中的标准化评分系统的最终实现。

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  • 来源
    《Allergy》 |2018年第9期|共9页
  • 作者单位

    Food Allergy Referral Centre Veneto RegionPadua General University HospitalPadua Italy;

    Allergy DepartmentHospital Clinico San CarlosMadrid Spain;

    Department of Pediatric Pneumology and ImmunologyCharité Universit?tsmedizin BerlinBerlin Germany;

    Allergy SectionHospital Universitari Vall d'HebronBarcelona Spain;

    Allergy SectionUniversity of CambridgeCambridge UK;

    Odense Research Center for AnaphylaxisOdense University HospitalOdense Denmark;

    Paediatrics and Child HealthUniversity College CorkCork Ireland;

    Wroclaw Medical UniversityWroclaw Poland;

    Asthma UK Centre for Applied ResearchThe University of EdinburghEdinburgh UK;

    Faculty of MedicineTransylvania University BrasovBrasov Romania;

    Murdoch Children's Research InstituteRoyal Children's HospitalMelbourne Vic Australia;

    Department of Immunology and AllergyNorthern General HospitalSheffield UK;

    Allergy UnitUniversity Hospital ZürichZürich Switzerland;

    Allergy UnitUniversity Hospital of AnconaAncona Italy;

    Odense Research Center for AnaphylaxisOdense University HospitalOdense Denmark;

    Department of Emergency MedicineMassachusetts General HospitalBoston MA USA;

    Allergy And Immunology DivisionThe University of PennsylvaniaPhiladelphia PA USA;

    Paediatrics and Child HealthUniversity College CorkCork Ireland;

    Pediatric Allergy UnitUniversity Hospitals of GenevaGeneva Switzerland;

    Hans Christian Andersen Children's HospitalOdense University HospitalOdense Denmark;

    Department of Pathophysiology and Allergy ResearchMedical University of ViennaVienna Austria;

    Department of Pediatric Pneumology and ImmunologyCharité Universit?tsmedizin BerlinBerlin Germany;

    Department of Clinical Science and EducationKarolinska Institutet and Sachs’ Children's;

    Allergy ClinicCopenhagen University HospitalCopenhagen Denmark;

    Klinik und Poliklinik für Dermatologie und AllergologieLudwig‐Maximilians‐Universit?tMunich Germany;

    The Children's Hospital of PhiladelphiaPerelman School of Medicine at University of;

    Department of Dermatology and VenerologyMedical University of Graz and Outpatient Allergy Clinic;

    Netherlands Anaphylaxis NetworkDordrecht The Netherlands;

    Allergy UnitIBIMAMálaga Spain;

    Section of Paediatrics (Allergy and Infectious Diseases) and MRCImperial College LondonLondon UK;

    Department of Experimental Immunology and OtorhinolaryngologyUniversity of AmsterdamAmsterdam The;

    Centre for Allergy ResearchKarolinska InstitutetStockholm Sweden;

    Department of Dermatology and AllergyCharité‐Universit?tsmedizinBerlin Germany;

    Centre for Respiratory Medicine and AllergyThe University of ManchesterManchester UK;

    NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学免疫学;
  • 关键词

    allergic reactions; anaphylaxis; drug allergy; food allergy; severity score; venom allergy;

    机译:过敏反应;过敏反应;药物过敏;食物过敏;严重程度;毒液过敏;

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