ArticleClinical and translational allergy2018
Assessing severity of anaphylaxis: a data-driven comparison of 23 instruments.
Article in Clinical and translational allergy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Comparative evaluation of seven severity grading systems in pediatric oral food challenges: Distinctions between anaphylactic and non-anaphylactic reactions.The World Allergy Organization journal · 2026Article
- IgE levels correlate with FcFrontiers in allergy · 2026Article
- Anaphylaxis severity grade, during oral food challenges, assessed by five different classifications.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Observational
- The Application of Knowledge-Based Clinical Decision Support Systems to Detect Antibiotic Allergy.Antibiotics (Basel, Switzerland) · 2024Article
- Updated grading system for systemic allergic reactions: Joint Statement of the World Allergy Organization Anaphylaxis Committee and Allergen Immunotherapy Committee.The World Allergy Organization journal · 2024Review
- How to define severity: A review of allergic reaction severity scoring systems.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023Review
- Anaphylaxis management in a French pediatric emergency department: Lessons from the ANA-PED study.Clinical and translational allergy · 2023Article
- Article
- A Clinical Practice Guideline for the Emergency Management of Anaphylaxis (2020).Frontiers in pharmacology · 2022Article
- Improving Severity Scoring of Food-Induced Allergic Reactions: A Global "Best-Worst Scaling" Exercise.The journal of allergy and clinical immunology. In practice · 2021Article
- Is the clinical manifestation of anaphylaxis in children influenced by the trigger of reaction?Postepy dermatologii i alergologii · 2021Article
- Therapeutic applications and biological activities of bacterial bioactive extracts.Archives of microbiology · 2021Review
- Recent update on the management of anaphylaxis.Clinical and experimental emergency medicine · 2021Article
- Anaphylaxis to the first dose of mRNA SARS-CoV-2 vaccines: Don't give up on the second dose!Allergy · 2021Article
- Patients with suspected allergic reactions to COVID-19 vaccines can be safely revaccinated after diagnostic work-up.Clinical and translational allergy · 2021Article
- World allergy organization anaphylaxis guidance 2020.The World Allergy Organization journal · 2020Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroudThe severity of an allergic reaction can range from mild local symptoms to anaphylactic shock. To score this, a number of instruments have been developed, although heterogeneous in design and purpose. Severity scoring algorithms are therefore difficult to compare, but are frequently used beyond their initial purpose. Our objective was to compare the most used severity scoring instruments by a data-driven approach on both milder reactions and anaphylaxis.
methodsAll positive challenges to foods or drugs (n = 2828) including anaphylaxis (n = 616) at Odense University Hospital, Denmark from 1998 to 2016 were included and severity was scored according to Sampson5. Based on recommendations from an expert group, the symptoms and values from Sampson5 were for all reactions and anaphylaxis only translated and compared by kappa statistics with 22 instruments, ranging from 3 to 6 steps.
resultsFor milder reactions, there was a significant correlation between the number of steps in an instrument and the number of challenges that could be translated, whereas all instruments were good to identify food anaphylaxis. Some instruments scored reactions more severely than Sampson5, other scored them milder and some scored food and drug challenges differently. Instruments for hymenoptera reactions were difficult to apply on food and drug reactions, and thus distributed severity differently. Algorithms hampered the translation between instruments, and 7 instruments were poor concerning drug anaphylaxis, including the only instrument developed specifically for drug reactions.
conclusionThe distributions of severity differed between the 23 instruments in both food and drug allergy, and thus rendering translation especially between scoring systems with 3 and 5 grades difficult. Fine-graded and simple instruments are preferred for comparison especially among milder reactions, and instruments applied to non-intended situations may not reflect a true severity picture.
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