Pooled Analysis of the Cow's Milk-related-Symptom-Score (CoMiSS™) as a Predictor for Cow's Milk Related Symptoms.
10.5223/pghn.2017.20.1.22
- Author:
Yvan VANDENPLAS
1
;
Philippe STEENHOUT
;
Anette JÄRVI
;
Anne Sophie GARREAU
;
Rajat MUKHERJEE
Author Information
1. Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. yvan.vandenplas@uzbrussel.be
- Publication Type:Original Article
- Keywords:
Cow's milk protein allergy;
Cow's milk-related-symptom-score extensive hydrolysate
- MeSH:
Diagnosis;
Humans;
Hypersensitivity;
Infant;
Logistic Models;
Milk*;
Primary Health Care;
Prospective Studies;
Statistics as Topic
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2017;20(1):22-26
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The diagnosis of cow's milk (CM) allergy is a challenge. The Cow's Milk-related-Symptom-Score (CoMiSS™) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the CoMiSS™ was evaluated in three clinical trials. METHODS: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 challenge test on the month-1 CoMiSS™, adjusting for baseline CoMiSS™ using a logistic regression model. In addition a logistic regression model was also fitted to the month-1 challenge test result with the change in CoMiSS™ from baseline as a predictor. RESULTS: Results suggest that infants having a low CoMiSS™ (median, 5) after 1 month dietary treatment free from intact CM protein have a significant risk of having a positive challenge test (odds ratio, 0.83; 95% confidence interval, 0.75-0.93; p=0.002). Pooled data suggest that the change in CoMiSS™ from baseline to month-1 can predict CM related symptoms as a confirmed diagnosis according to the challenge test at month-1. However, in order to validate such a tool, infants without CM related symptoms would also need to be enrolled in a validation trial. A concern is that it may not be ethical to expose healthy infants to a therapeutic formula and a challenge test. CONCLUSION: Pooled data analysis emphasizes that the CoMiSS™ has the potential to be of interest in infants suspected to have CM-related-symptoms. A prospective validation trial is needed.
