Evidence map›Paper›PMID 36277549›Full record

ArticleCureus2022

Real World Management of Anaphylaxis Versus the National Institute for Health and Clinical Excellence (NICE) Guidelines.

Iman Nasr, Asmaa S Mahdi, Jalila Al Shekaili, Ikram Nasr, Humaid Al Wahshi, Saad Al Juma, Latifa Al Shukeili, Ibrahim Al Zakwani, Issa Al Salmi

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Iman NasrAllergy and Immunology, The Royal Hospital, Muscat, OMN.
Asmaa S MahdiAllergy and Immunology, The Royal Hospital, Muscat, OMN.
Jalila Al ShekailiAllergy and Immunology, Sultan Qaboos University Hospital, Seeb, OMN.
Ikram NasrGastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, GBR.
Humaid Al WahshiRheumatology, The Royal Hospital, Muscat, OMN.
Saad Al JumaEmergency Department, The Royal Hospital, Muscat, OMN.
Latifa Al ShukeiliAllergy and Immunology, Al Nahdah Hospital, Muscat, OMN.
Ibrahim Al ZakwaniPharmacy, Sultan Qaboos University Hospital, Seeb, OMN.
Issa Al SalmiNephrology, The Royal Hospital, Muscat, OMN.
Al Nahdha Hospital · OMGuy's and St Thomas' NHS Foundation Trust · GBRoyal Hospital · OMSultan Qaboos University Hospital · OM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives  Anaphylaxis is an acute, life-threatening immediate allergic reaction caused by the sudden systemic release of mediators from mast cells. This study aims to assess the current practice of emergency management of children and adults diagnosed with anaphylaxis at the Royal Hospital, Muscat, Oman, in line with the National Institute for Health and Clinical Excellence (NICE) guidelines.  Methods This is an observational retrospective study of all anaphylaxis cases seen at the emergency department (ED) from January 2013 to January 2018 and compared with the management of anaphylaxis in the ED as per the NICE guidelines. Inclusion criteria were all patients, children (age 16 and below), and adults diagnosed with anaphylaxis based on the World Allergy Organization (WAO) criteria. Exclusion criteria are all cases labeled as anaphylaxis that did not match the WAO criteria for anaphylaxis. Results Of 100 patients with a preliminary diagnosis of anaphylaxis, 49 patients (49%) were true-anaphylaxis cases based on the WAO definition 16 were children (age 16 years and below), and 33 were adults ( age 16 years and above). The other 51 patients (51%) with misdiagnosed anaphylaxis were later diagnosed with spontaneous urticaria, septic shock, vocal cord dysfunction, severe asthma, and anxiety attack. All 49 patients with true-anaphylaxis appropriately received adrenaline intramuscularly at the ED. All 16 children were admitted, seen by an allergist, and received an adrenaline auto-injector when indicated. Only 5 of the 33 adults were admitted and seen by an allergist, and 4 of those required an adrenaline auto-injector upon discharge. The remaining 28 adults were discharged from the ED, and only 3 of these were referred to the allergist. None received an adrenaline auto-injector upon discharge from the ED, and no mention in the ED notes on patient education regarding allergen avoidance. Conclusion Third of the patients who presented to ED were children (<16 years), and two third were adults. Insect venom was the main reason for anaphylaxis in both age groups. There was an underutilization of adrenaline auto-injector prescriptions for adult patients. This could be very well improved by disseminating policies and guidelines to adult physicians.

Indexed as

adrenaline auto-injectoranaphylaxisangioedemanice guidelinesomanurticaria

Identifiers

PMID36277549
PMCPMC9581108
OpenAlexW4296293314

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.