چکیده (انگلیسی):

Background: We have proposed a new scoring system (Anaphylaxis SCoring Aichi: ASCA) for a quantitative
evaluation of the anaphylactic reaction that is observed in an oral food challenge (OFC). Furthermore,
the TS/Pro (Total Score of ASCA/cumulative protein dose) can be a marker to represent the overall
severity of a food allergy. We aimed to develop a prediction model for a severe allergic reaction that is
provoked in a boiled egg white challenge.
Methods: We used two separate datasets to develop and validate the prediction model, respectively. The
development dataset included 198 OFCs, that tested positive. The validation dataset prospectively
included 140 consecutive OFCs, irrespective of the result.
A ‘severe reaction’ was defined as a TS/Pro higher than 31 (the median score of the development dataset).
A multivariate logistic regression analysis was performed to identify the factors associated with a severe
reaction and develop the prediction model.
Results: The following four factors were independently associated with a severe reaction: ovomucoid
specific IgE class (OM-sIgE: 0e6), aged 5 years or over, a complete avoidance of egg, and a total
IgE < 1000 IU/mL. Based on these factors, we made a simple scoring prediction model. The model
showed good discrimination in a receiver operating characteristic analysis; area under the curve
(AUC) ¼ 0.84 in development dataset, AUC ¼ 0.85 in validation dataset. The prediction model significantly
improved the AUC in both datasets compared to OM-sIgE alone.
Conclusions: This simple scoring prediction model was useful for avoiding risky OFC.