Hopkins, PM orcid.org/0000-0002-8127-1739, Cooke, PJ, Clarke, RC et al. (22 more authors) (2019) Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions. British Journal of Anaesthesia, 123 (1). e29-e37. ISSN 0007-0912
Abstract
Background
Grading schemes for severity of suspected allergic reactions have been applied to the perioperative setting, but there is no scoring system that estimates the likelihood that the reaction is an immediate hypersensitivity reaction. Such a score would be useful in evaluating current and proposed tests for the diagnosis of suspected perioperative immediate hypersensitivity reactions and culprit agents.
Methods
We conducted a Delphi consensus process involving a panel of 25 international multidisciplinary experts in suspected perioperative allergy. Items were ranked according to appropriateness (on a scale of 1–9) and consensus, which informed development of a clinical scoring system. The scoring system was assessed by comparing scores generated for a series of clinical scenarios against ratings of panel members. Supplementary scores for mast cell tryptase were generated.
Results
Two rounds of the Delphi process achieved stopping criteria for all statements. From an initial 60 statements, 43 were rated appropriate (median score 7 or more) and met agreement criteria (disagreement index <0.5); these were used in the clinical scoring system. The rating of clinical scenarios supported the validity of the scoring system. Although there was variability in the interpretation of changes in mast cell tryptase by the panel, we were able to include supplementary scores for mast cell tryptase.
Conclusion
We used a robust consensus development process to devise a clinical scoring system for suspected perioperative immediate hypersensitivity reactions. This will enable objectivity and uniformity in the assessment of the sensitivity of diagnostic tests.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. This is an author produced version of a paper published in the British Journal of Anaesthesia. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | allergy, anaesthesia, anaphylaxis, drug hypersensitivity, perioperative period, surgery |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) > Trans Anaesthetics & Surgical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 Apr 2019 11:26 |
Last Modified: | 24 Apr 2020 00:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.bja.2019.02.029 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145473 |
Download
Filename: Special Article 3 Manuscript final accepted version.pdf
Licence: CC-BY-NC-ND 4.0