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        Pooled Analysis of the Cow's Milk-related-Symptom-Score (CoMiSS<sup>TM</sup>) as a Predictor for Cow's Milk Related Symptoms

        Vandenplas, Yvan,Steenhout, Philippe,Jarvi, Anette,Garreau, Anne-Sophie,Mukherjee, Rajat The Korean Society of Pediatric Gastroenterology 2017 Pediatric gastroenterology, hepatology & nutrition Vol.20 No.1

        Purpose: The diagnosis of cow's milk (CM) allergy is a challenge. The Cow's Milk-related-Symptom-Score ($CoMiSS^{TM}$) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the $CoMiSS^{TM}$ 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 $CoMiSS^{TM}$, adjusting for baseline $CoMiSS^{TM}$ 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 $CoMiSS^{TM}$ from baseline as a predictor. Results: Results suggest that infants having a low $CoMiSS^{TM}$ (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 $CoMiSS^{TM}$ 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 $CoMiSS^{TM}$ has the potential to be of interest in infants suspected to have CM-related-symptoms. A prospective validation trial is needed.

      • KCI등재

        Pooled Analysis of the Cow’s Milk-related-Symptom-Score (CoMiSSTM) as a Predictor for Cow’s Milk Related Symptoms

        Yvan Vandenplas,Philippe Steenhout,Anette Järvi,Anne-Sophie Garreau,Rajat Mukherjee 대한소아소화기영양학회 2017 Pediatric gastroenterology, hepatology & nutrition Vol.20 No.1

        Purpose: The diagnosis of cow’s milk (CM) allergy is a challenge. The Cow’s Milk-related-Symptom-Score (CoMiSSTM) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the CoMiSSTM was evaluated in three clinical trials. Methods: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 chal-lenge test on the month-1 CoMiSSTM, adjusting for baseline CoMiSSTM 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 CoMiSSTM from baseline as a predictor. Results: Results suggest that infants having a low CoMiSSTM (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 CoMiSSTM 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 CoMiSSTM has the potential to be of interest in infants sus-pected to have CM-related-symptoms. A prospective validation trial is needed.

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