The Cow Milk Symptom Score (CoMiSSTM) in presumed healthy infants

Vandenplas, Yvan; Salvatore, Silvia; Ribes-Koninckx, Carmen; Carvajal, Eva; Szajewska, Hania; Huysentruyt, Koen

doi:10.1371/journal.pone.0200603

Cited by 37 publications

(65 citation statements)

References 13 publications

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“…It is possible that by performing the scoring at home, a larger difference may be observed due to a longer time span between recording by the parents and the consultation with the pediatrician. According to the analysis of the data obtained in a population of presumed healthy infants, a score of >10 was proposed as the best cut-off value [2]. A recent Italian study evaluated the CoMiSS in symptomatic infants, proposing a cut-off of >9 [5].…”

Section: Discussionmentioning

confidence: 99%

“…Feeding, breastfeeding o formula feeding, had no influence on the CoMiSS. When scored by parents, eight (5.4%) infants had a score >12, which was initially proposed as the cut-off (1) and 12 (8.1%) infants had a score >10, which came up as the best cut-off according to the data obtained in presumed healthy infants (2). Similar results were seen when scored by HCP: seven (4.7%, p = 0.791) scored ≥12 and 11 (7.4%, p = 0.828) scored >10.…”

Section: Hcp Versus Parentmentioning

confidence: 99%

“…It is a symptom based score with the additional aim of evaluating evolution during a therapeutic intervention. As most of the symptoms in the CoMiSS are nonspecific on themselves, we recently investigated the performance of the CoMiSS in a large cohort of presumed healthy infants [2]. This resulted in a median value of 3 for healthy infants and a 95th centile of 9, which led us to propose a change in cut-off value from ≥12 to >10 for a 'positive' CoMiSS [2].…”

Section: Introductionmentioning

confidence: 99%

“…As most of the symptoms in the CoMiSS are nonspecific on themselves, we recently investigated the performance of the CoMiSS in a large cohort of presumed healthy infants [2]. This resulted in a median value of 3 for healthy infants and a 95th centile of 9, which led us to propose a change in cut-off value from ≥12 to >10 for a 'positive' CoMiSS [2]. Polish data are in alignment with these findings as the median (Q1-Q3) and mean (SD) CoMiSS™ values were 4 (2-7) and 4.7 (3.5), respectively [3].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Hcp Versus Parentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…As CoMiSS™ values in presumed healthy infants remain limited, the collection of age-related CoMiSS™ data is needed. In 2017, a multicenter, cross-sectional study was conducted in four European countries with the aim of determining an age-related CoMiSS™ in presumed healthy infants [4]. The availability of such data is important to establishing a cut-off value for this tool to identify infants requiring further evaluation.…”

Section: Introductionmentioning

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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A nomogram for predicting food allergy in infants with feeding problems and malnutrition

Yang,

Zhou,

et al. 2024

J. pediatr. gastroenterol. nutr.

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Background and ObjectiveAs oral food challenge (OFC) cannot be performed routinely in the general outpatient, this study aimed to construct a nomogram to predict the odds of food allergy in infants with idiopathic feeding problems and malnutrition.MethodsFrom August 2018 to December 2021, 289 infants (median age, 6 months; P25–P75, 4–8) with idiopathic feeding problems and malnutrition were enrolled from seven hospitals in Shanghai, China. Food allergy was defined as a positive response to a skin prick test or OFC, with gastrointestinal, dermatologic, or respiratory symptom improvement after 4 weeks of avoidance of the suspected food. Demographic characteristics, Cow's Milk‐related Symptom Scores (CoMiSS), and blood eosinophil amounts were evaluated for their associations with food allergy. Multivariable logistic regression analysis was used to identify variables to develop a nomogram model with the bootstrapped‐concordance index as an assessment metric.ResultsTotally 249 of 289 infants had food allergy (86.2%). After logistic regression analysis, the feeding pattern (odds ratio [OR] = 5.28, 95% confidence interval [CI]: 2.13–13.09), a family history of allergy (OR = 1.79, 95% CI: 0.71–4.51), CoMiSS (OR = 1.45, 95% CI: 1.19–1.77), and eosinophil percentage (OR = 1.33, 95% CI: 1.11–1.60) were used to develop the model, which had a good performance with an area under the curve of 0.868 (95% CI: 0.792–0.944) and a bootstrapped‐concordance index of 0.868.ConclusionFood allergy is common in infants with idiopathic feeding problems and malnutrition. The developed nomogram may help identify infants with food allergy for further diagnosis.

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The Cow Milk Symptom Score (CoMiSSTM) in presumed healthy infants

Cited by 37 publications

References 13 publications

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

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

A nomogram for predicting food allergy in infants with feeding problems and malnutrition

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