Evidence map›Paper›PMID 40043695›Full record

ArticleInternational archives of allergy and immunology2025

Predicting Cow's Milk Challenge Outcomes in Children: Multivariate Analysis of Clinical Predictors.

Luca Delli Colli, Luca Delli Colli, Joshua Yu, Derek Lanoue, Adhora Mir, Casey G Cohen, Diana Toscano-Rivero, Justin Sacksner, Bruce Mazer, Christine McCusker and 12 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International archives of allergy and immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Casein sIgE as the most accurate predictor for heated milk tolerance in Finnish children.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025
    Article
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

22 authors.

Luca Delli Colli
Luca Delli ColliDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Joshua YuDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Derek LanoueDivision of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Centre, McGill University, Montreal, Québec, Canada.
Adhora MirDepartment of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Casey G CohenDivision of Experimental Medicine, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montreal, Québec, Canada.
Diana Toscano-RiveroDivision of Experimental Medicine, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montreal, Québec, Canada.
Justin SacksnerDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Bruce MazerDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Christine McCuskerDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Danbing KeDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Vera LaboccettaDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Duncan LejtenyiDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Liane BeaudetteDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.
Edmond S ChanDivision of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Ingrid BaergDivision of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Julia UptonDivision of Immunology and Allergy, Department of Pediatrics, The Hospital of Sick Children, University of Toronto, Toronto, Ontario, Canada.
Eyal GrunebaumDivision of Immunology and Allergy, Department of Pediatrics, The Hospital of Sick Children, University of Toronto, Toronto, Ontario, Canada.
Philippe BéginDivision of Allergy and Clinical Immunology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Québec, Canada.
Ann E ClarkeDivision of Rheumatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Aaron JonesDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Moshe Ben-ShoshanDivision of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: Oral food challenges are the gold standard for diagnosis and reactivity thresholds but are resource intensive and high risk for reactions. Limited data on factors associated with increased risk of positive oral food challenges exist. We aimed to assess factors associated with positive oral food challenges and create a model to predict cow milk oral food challenge outcomes.

methodsChildren aged 5-18 being considered for cow's milk oral immunotherapy underwent a single-blind, placebo-controlled food challenge to cow's milk, with either positive (reaction) or negative (tolerance) outcomes. Initial factors recorded included sex, age, history of asthma, eczema, allergic rhinitis, prior epinephrine use for cow's milk-induced reactions, skin prick test size, serum levels of immunoglobulin E antibodies to α-lactalbumin, β-lactoglobulin, and casein, and log-transformed values. Stepwise backward multivariate Firth bias-reduced logistic regression was used to create the final model, and performance was assessed with receiver operator characteristic curves.

resultsA total of 111 children underwent an oral food challenge, 103 patients reacted, and 8 tolerated the challenge. Univariate analysis showed skin prick test size, previous epinephrine use, history of asthma, and log-transformed α-lactalbumin, β-lactoglobulin, and casein were significantly associated with positive oral food challenge. The multivariate model included two factors: log-transformed casein (aOR 2.4; 95% CI: 1.4-5.9; p < 0.001) and previous epinephrine use (aOR 6.5; 95% CI: 1.2-68.0; p = 0.03). The final model showed good discriminatory performance (AUC 0.928; 95% CI: 0.83-0.98). In comparison, a univariate model using only the skin prick test (OR 1.44, 95% CI: 1.1-2.0; p = 0.002) had worse discriminatory performance (AUC 0.83; 95% CI: 0.64-0.93).

conclusionThe study suggests that logistic multivariate models, including log-transformed casein and previous epinephrine use, may help predict oral food challenge outcomes in pediatric patients. Future studies are needed to validate this with larger datasets. </p>.

Indexed as

AllergensMilkMilk HypersensitivityAdolescentAnimalsCattleChildChild, PreschoolDesensitization, ImmunologicFemaleHumansImmunoglobulin EMaleMultivariate AnalysisSingle-Blind MethodSkin TestsAllergensImmunoglobulin EAllergen challengeAllergy diagnosisCaseinCow’s milkPredictive model

Identifiers

PMID40043695
PMCPMC12013213

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.