ArticleThe World Allergy Organization journal2026
Comparative evaluation of seven severity grading systems in pediatric oral food challenges: Distinctions between anaphylactic and non-anaphylactic reactions.
Article in The World Allergy Organization journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Multiple severity scoring systems exist for classifying reactions during OFCs; however, the lack of uniformity among them results in inconsistent identification and management of anaphylaxis. Objective: This study aimed to evaluate the clinical characteristics and severity of anaphylactic and non-anaphylactic reactions during oral food challenges (OFCs) in children and to compare the concordance and discrepancies among 7 different severity scoring systems. Methods: In this single-center, retrospective, and observational study, positive OFCs were retrospectively graded using 7 different severity classification systems. The concordance and discrepancies among the classification systems, including the World Allergy Organization (WAO) 2024 criteria, the International Classification of Diseases 11th Revision (ICD-11), and the European Academy of Allergy and Clinical Immunology (EAACI) classifications, were evaluated. Results: Of the 1901 OFCs performed on 855 patients, 344 (18.1%) were positive, and among these, 61 (17.7%) were classified as anaphylactic reactions. Patients with anaphylactic reactions were significantly older than those with non-anaphylactic reactions (median age: 27 months vs. 15 months; p < 0.001). Using the WAO2024 criteria as the reference standard, both ICD-11 and EAACI classifications showed 100% sensitivity, while specificity for all systems ranged from 86.2% to 99.3%. Discrepancies among severity scoring systems were primarily due to differences in the interpretation of gastrointestinal manifestations. EAACI showed the most favorable balance between sensitivity and specificity, whereas CoFAR and Dribin demonstrated the highest specificity. Conclusion: The findings emphasize the need for a harmonized severity classification system that is applicable in both clinical practice and research. Such standardization would enhance diagnostic accuracy and improve the management of food allergies in children.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.