Evidence map›Paper›PMID 41323127›Full record

ArticleThe World Allergy Organization journal2025

Food allergy severity across the world: A World Allergy Organization international survey.

Stefania Arasi, Mário Morais-Almeida, Bryan L Martin, Gary Wing-Kin Wong, Ignacio J Ansotegui, Motohiro Ebisawa, Adnan Custovic, Alexandra Santos, Anna Nowak-Wegrzyn, Andrew Stoddart and 55 more

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Article in The World Allergy Organization journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing 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

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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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

65 authors.

Stefania ArasiAllergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Mário Morais-AlmeidaAllergy Center, CUF Descobertas Hospital, Lisbon, Portuguese Republic.
Bryan L MartinMedicine and Pediatrics, The Ohio State University, Columbus, Ohio, United States.
Gary Wing-Kin WongThe Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
Ignacio J AnsoteguiHospital Quironsalúd Bizkaia, Bilbao, Spain.
Motohiro EbisawaSagamihara National Hospital, Sagamihara, Japan.
Adnan CustovicDepartment of Paediatrics, Imperial College London, London, United Kingdom.
Alexandra SantosKing's College London, and Evelina London Children's Hospital, Guy's and St. Thomas' Hospital, London, United Kingdom.
Anna Nowak-WegrzynNew York University School of Medicine, Langone Health, New York, United States.
Andrew StoddartUniversity of Edinburgh, Edinburgh, United Kingdom.
Antoine DeschildreHospital Center University of Lille, Hôpital Jeanne de Flandre, Lille, France.
Antonella CianferoniThe Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Antonella MuraroFood Allergy Centre Department of Woman and Child Health, Padua University Hospital, Padua, Italy.
Audrey DunnGalvinApplied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland.
Brian VickeryDepartment of Pediatrics, Emory University, Atlanta, Georgia, United States.
Carina VenterSection of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, United States.
Carla JonesAllergy UK, London, United Kingdom.
Carmen MazzucaAllergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Christopher WarrenCenter for Food Allergy and Asthma Research, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States.
Daniel MunblitInflammation, Repair and Development Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
David B PedenCenter for Environmental Medicine, The School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
David FleischerUniversity of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado, United States.
Elham HossnyPediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Graham RobertsUniversity Hospital Southampton, Southampton, United Kingdom.
Hania SzajewskaDepartment of Paediatrics, The Medical University of Warsaw, Warsaw, Republic of Poland.
Helen A BroughChildren's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital, London, United Kingdom.
James L SublettDepartment of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, Louisville, Kentucky, United States.
Jonathan A BernsteinDivision of Immunology/Allergy Section, Department of Internal Medicine, University of Cincinnati College of Medicine, Bernstein Allergy Group, Bernstein Clinical Research Center, Cincinnati, Ohio, United States.
José Antonio Ortega-MartellUniversidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México.
Liang-Lu WangDepartment of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, People's Republic of China.
Luciana Kase TannoDivision of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology University Hospital of Montpellier, Montpellier, France.
Luis CaraballoInstitute for Immunological Research, University of Cartagena, Cartagena, Republic of Colombia.
Manana ChikhladzeMedical Faculty at Akaki Tsereteli State University, National Institute of Allergy, Asthma & Clinical Immunology, KuTaisi, Tskaltubo, Georgia.
Marcia PodestàEFA - European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
Marcus S ShakerDartmouth Geisel School of Medicine, New Hampshire, United States.
María Antonieta Guzmán MeléndezSection of Immunology, HIV and Allergy, Department of Medicine, Clinical Hospital University of Chile, Santiago, Chile.
Maria SaidNational Allergy Council, and Allergy & Anaphylaxis Australia, Sydney, Australia.
Marta Vazquez-OrtizSection of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Martin BozzolaPediatric Allergy and Immunology Section, Department of Pediatrics, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.
Matthew GreenhawtChildren's Hospital Colorado, University of Colorado School of Medicine, Section of Allergy and Clinical Immunology, Aurora, Colorado, United States.
Michael LevinDivision of Paediatric Allergology, Department of Paediatrics, University of Cape Town, South Africa.
Montserrat Álvaro LozanoUniversitat de Barcelona, Allergology and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain.
Nikolaos G PapadopoulosAllergy Department, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
Olga Patricia Monge OrtegaAllergy Unit, Hospital San Juan de Dios - Caja Costarricense de Seguro Social, San José, Republic of Costa Rica.
Paul J TurnerPaediatric Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Paula KauppiHeart and Lung Center, Department of Respiratory Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Pedro Giavina-BianchiClinical Immunology and Allergy Division, University of Sao Paulo, São Paulo, Brazil.
Philip W RouadiDepartment of Otolaryngology, Dar Al Shifa Hospital, Hawally, Kuwait.
Philippe BéginSection of Allergy Immunology and Rheumatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Quebec, Canada.
Philippe EigenmannPediatric Allergy Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
R Maximiliano GómezFaculty of Health Sciences, Catholic University of Salta, Salta, Argentina.
Robert J BoyleNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Ruchi S GuptaNorthwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA.
Sayantani B SindherSean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Palo Alto, California, United States.
R Sharon ChinthrajahSean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford University, Palo Alto, California, United States.
Tonya WindersGlobal Allergy and Airways Patient Platform, Vienna, Austria.
Ulugbek NurmatovDivision of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom.
Victoria CardonaAllergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, ARADyAL Research Network, Barcelona, Spain.
Yoon-Seok ChangDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Jennifer GerdtsFood Allergy Canada, North York, Ontario, Canada.
Renata RapilloDepartment of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Michele Miraglia Del GuidiceDepartment of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Vincenzo PatellaPostgraduate Program in Allergy and Clinical Immunology, University of Naples 'Federico II', Naples, Italy.
Alessandro FiocchiAllergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Lamia DahdahAllergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Data on severity of food allergy across nations are lacking. Building on the World Allergy Organization (WAO) DEFASE (Definition of Food Allergy Severity) score, we aim to explore its global applicability as a grading system for IgE-mediated food allergy (FA) severity. Methods: An international survey (WAO FASE Project) was conducted using an online questionnaire distributed to WAO members. The survey collected detailed data on diagnostic practices, therapeutic options, characteristics of FA patients, severity of reactions (including anaphylaxis), and eliciting doses of allergenic foods. In addition, FA management costs were examined (medical expenses, medication costs, and impact on quality of life and productivity). Results: We obtained information from 157 centers in 50 countries. FA management varied significantly across regions. Oral immunotherapy and omalizumab are widely used in Europe and North America. The use of advanced diagnostic tests (molecular diagnostics) vary widely between these regions. Thirty-five percent of patients with anaphylaxis exhibited severe symptoms (respiratory or cardiovascular compromise), with marked regional differences: more frequent in Western Asia (55.83%), Southern Africa (50%), and less frequent in South-Eastern Asia (12.5%) and Central America (21.72%). Approximately 1 in 4 patients reacted to less than half an age-appropriate portion of the allergenic food. Depending on the region, peanut, milk, egg, wheat, hazelnut, and peach allergies varied considerably. Economic resources and healthcare systems play an important role in determining access to diagnostic tests and therapeutic options, which have a direct impact on the severity and management of FA. Conclusions: With wide global disparities in access to diagnostic and therapeutic tools for food allergies, this condition entails a vast healthcare and economic commitment. The percentage of patients receiving a high severity diagnosis using DEFASE could be around 3%, similar to that of asthma patients diagnosed with severe refractory asthma.

Indexed as

AnaphylaxisEconomicsEpidemiologyFood hypersensitivitySurveys and questionnaires

Identifiers

PMID41323127
PMCPMC12657590

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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.