Severity grading system for acute allergic reactions: A multidisciplinary Delphi study
Autor: | Julie Wang, Yin Zhang, Mariana Castells, Lynda C. Schneider, Marcus Shaker, David Vyles, Susan A. Rudders, Carlos A. Camargo, David C. Brousseau, Timothy E. Dribin, David Schnadower, Michael Pistiner, Kenneth A. Michelson, John K. Witry, Peter Capucilli, Ronna L. Campbell, Kimberly A. Risma, Mark I. Neuman, Hugh A. Sampson, Jonathan M. Spergel, Rakesh D. Mistry, Amal Assa'ad, Juhee Lee |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Emergency Medical Services Consensus Delphi Technique Immunology Delphi method Severity grading macromolecular substances Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Multidisciplinary approach medicine Hypersensitivity Immunology and Allergy Humans 030212 general & internal medicine Clinical care Intensive care medicine Anaphylaxis Management practices business.industry Limiting Emergency department 030228 respiratory system Acute Disease Anaphylactic shock business |
Zdroj: | The Journal of allergy and clinical immunology. 148(1) |
ISSN: | 1097-6825 |
Popis: | Background There is no widely adopted severity grading system for acute allergic reactions, including anaphylactic and nonanaphylactic reactions, thus limiting the ability to optimize and standardize management practices and advance research. Objective The aim of this study was to develop a severity grading system for acute allergic reactions for use in clinical care and research. Methods From May to September 2020, we convened a 21-member multidisciplinary panel of allergy and emergency care experts; 9 members formed a writing group to critically appraise and assess the strengths and limitations of prior severity grading systems and develop the structure and content for an optimal severity grading system. The entire study panel then revised the grading system and sought consensus by utilizing Delphi methodology. Results The writing group recommended that an optimal grading system encompass the severity of acute allergic reactions on a continuum from mild allergic reactions to anaphylactic shock. Additionally, the severity grading system must be able to discriminate between clinically important differences in reaction severity to be relevant in research while also being intuitive and straightforward to apply in clinical care. Consensus was reached for all elements of the proposed severity grading system. Conclusion We developed a consensus severity grading system for acute allergic reactions, including anaphylactic and nonanaphylactic reactions. Successful international validation, refinement, dissemination, and application of the grading system will improve communication among providers and patients about the severity of allergic reactions and will help advance future research. |
Databáze: | OpenAIRE |
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