WAO consensus on DEfinition of Food Allergy SEverity (DEFASE)

Authors: Stefania Arasi, Ulugbek Nurmatov, Audrey DunnGalvin, Graham Roberts, Paul Turner, Sayantani B. Shinder, Ruchi S. Gupta, Philippe Eigenmann, Anna Nowak‐Węgrzyn, Ignacio J. Ansotegui, Montserrat Fernández‐Rivas, Stavros Petrou, Luciana Kase Tanno, Marta Vázquez‐Ortiz, Brian P. Vickery, Gary Wong, Montserrat Álvaro‐Lozano, Miqdad Asaria, Philippe Bégin, Martín Bózzola, Robert Boyle, Helen A. Brough, Victória Cardona, R. Sharon Chinthrajah, Antonella Cianferoni, A. Deschildre, David M. Fleischer, Flavio Gazzani, Jennifer Gerdts, Marilena Giannetti, Matthew Greenhawt, María Antonieta Guzmán, Elham Hossny, Paula Kauppi, Carla Jones, Francesco Lucidi, Olga Patricia Monge-Ortega, Daniel Munblit, Antonella Muraro, Giovanni Battista Pajno, Márcia Helena Miranda Cardoso Podestá, Pablo Rodríguez del Río, Maria Said, Alexandra F. Santos, Marcus Shaker, Hania Szajewska, Carina Venter, Cristopher Warren, Tonya Winders, Motohiro Ebisawa, Alessandro Fiocchi - World Allergy Organization Journal 2023 cited by 53

Background: While several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole. Aim: To develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally. Methods Phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts. Phase 2: as being achieved if 70% or more of panel members rated a statement as "strongly agree" to "agree" after the second round. Based on feedback, 2 additional online voting rounds were conducted. Results: We received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score. Conclusions: The DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.