Cow’s Milk-related Symptom Score as a predictive tool for cow’s milk allergy in Indian children aged 0-24 months

Prasad, Rajniti; Venkata, Ravi Shankar Ayathu; Ghokale, Praveen; Chakravarty, Pavitra; Anwar, Fahmina

doi:10.5415/apallergy.2018.8.e36

Cited by 26 publications

(47 citation statements)

References 12 publications

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“…13,14 In another study by Prasad et al, 84.3% of the children were diagnosed with CMPA using CoMiSS with a cut-off value of ≥12, but the design of this study is quite different from ours. 15 In our study, using SBS ≥12 as the cut-off value and with a challenge test, 54.2% of the infants were diagnosed with CMPA. In the pilot study of CoMiSS by Vandenplas et al, 69% of the patients were diagnosed with CMPA, 10 which is higher than our study; however, they reported that cows milk challenge was not performed in some of the patients, whereas in our study, the challenge test was performed in all infants.…”

Section: Discussionmentioning

confidence: 61%

Assessment of cows milk‐related symptom scoring awareness tool in young Turkish children

Selbuz

Altuntaş

Kansu

et al. 2020

J Paediatrics Child Health

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Background: The diagnosis of cows milk protein allergy (CMPA) is not always easy. Cow's Milk-related Symptom Score (CoMiSS) has been developed to raise the awareness of CMPA among the primary health-care providers. In this study, we aimed to evaluate the validity of CoMiSS as a diagnostic approach of CMPA in infants in our country. Methods: Infants with a CoMiSS of more than 12 points were included. An elimination diet was implemented in these infants for 4 weeks, and CoMiSS was reapplied. Infants with a reduction of ≥3 points in CoMiSS were considered responsive to the elimination diet, and an open oral challenge test was performed. Infants with symptom recurrence were diagnosed with CMPA. Results: The study included 168 infants. When they were included in the study, the first CoMiSS score was 13.6 AE 1.9. After the elimination diet, the number of responsive infants was 154 (91.7%). Of the infants, 91 (54.2%) were diagnosed with CMPA with positive challenge. The majority of the patients diagnosed with CMPA presented with gastrointestinal and/or dermatological symptoms (80.3%). Positive family history of allergy was more prevalent in CMPA(+) infants (P < 0.001). The mean atopic dermatitis score was higher in CMPA(+) infants (P = 0.001). Eosinophilia and cows milk-specific IgE (CM-sIgE) positivity were more prevalent in infants with CMPA (P = 0.01 and P < 0.001, respectively). Conclusions: CoMiSS is a valuable tool to evaluate CMPA in primary care. The presence of multiple symptoms, especially skin involvement, helps to recognise infants with CMPA. Family history and eosinophilia also support the diagnosis of CMPA.

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Section: Discussionmentioning

confidence: 61%

Assessment of cows milk‐related symptom scoring awareness tool in young Turkish children

Selbuz

Altuntaş

Kansu

et al. 2020

J Paediatrics Child Health

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“…CoMiSS was reported to help in predicting CMPA in children aged less than 2 years in an Indian primary care setting, aiding in early diagnosis [6]. The next step is to confirm these data in symptomatic infants.…”

Section: Discussionmentioning

confidence: 97%

The Cow’s Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability

et al. 2020

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The Cow’s Milk-related Symptom Score (CoMiSSTM) was created as an awareness tool for cow’s milk allergy. The aim of the present study was to analyze the inter-rater variability between a pediatrician, parents, and day to day variability. A Health Care Professional (HCP) and parent filled in the CoMiSS independently and blinded for each other to evaluate inter-rater variability. In order to validate day-to-day variability, a parent filled in the CoMiSS during 3 consecutive days and was compared to the CoMiSS scored by the HCP. The absolute agreement between parent and HCP was 75%, and 92.6% and 100% with a tolerance of 0, 1, and 2 points, respectively, resulting in excellent agreement with an intraclass correlation coefficient (ICC) 0.981 (95% Confidence Interval 0.974–0.986, p < 0.001). Day-to-day variability during 3 consecutive days resulted in an absolute agreement of 30%, increasing to 80% and 88.6% when 2 and 3 points, respectively, were accepted. The ICC was excellent for the parental prospective scores (0.93, 95% CI 0.90–0.96; p < 0.001). Day-to-day variability indicates that CoMiSS has a moderate inter-rater reliability. A very low variability was observed when scored prospectively over three days. Data suggest that the CoMiSS can reliably be scored by parents without additional training.

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“…One of these studies was conducted in Indian children aged between 0 and 24 months. The positive and negative predictive values for the CoMiSS™ were 93% and 33%, respectively [6]. A second study was conducted in 38 Chinese children https://pghn.org https://doi.org/10.5223/pghn.2020.23.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Cow's Milk-Related Symptom Score in Presumed Healthy Polish Infants Aged 0–6 Months

Bigorajska

Filipiak

Winiarska

et al. 2020

Pediatr Gastroenterol Hepatol Nutr

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Purpose: The Cow's Milk-related Symptom Score (CoMiSS™), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. This study aimed to determine the age-related CoMiSS™ values in presumed healthy infants in Poland. Methods: This was a cross-sectional study conducted in well-child clinics in two locations. Parents of the presumed healthy infants aged ≤6 months were approached during a routine checkup/vaccination visit. The exclusion criteria were as follows: presence of acute or chronic diseases, preterm delivery, treatment with therapeutic formula, and use of any food supplements (except vitamins) or medications. Results: Data from 226 infants were obtained (median age [Q1-Q3], 4 months [3-4]). The overall median (Q1-Q3) and mean (standard deviation) CoMiSS™ values were 4 (2-7) and 4.7 (3.5), respectively. The 95th percentile was 11. Scores on some, albeit not all, components of the CoMiSS™ significantly differed between age groups (crying, stools) or feeding type groups (stools and skin symptoms). Eleven children (4.9%) scored ≥12. Conclusion: This study adds to earlier age-related CoMiSS™ data by providing CoMiSS™ values in presumed healthy infants in Poland.

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Cow’s Milk-related Symptom Score as a predictive tool for cow’s milk allergy in Indian children aged 0-24 months

Cited by 26 publications

References 12 publications

Assessment of cows milk‐related symptom scoring awareness tool in young Turkish children

Assessment of cows milk‐related symptom scoring awareness tool in young Turkish children

The Cow’s Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability

Cow's Milk-Related Symptom Score in Presumed Healthy Polish Infants Aged 0–6 Months

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