Study Inclusion criteria and selection Index test cut-off Index test examiner Reference standard(s) Definition of CMPA by reference standard
CMPA questionnaire CMPA questionnaire CMPA questionnaire CMPA questionnaire CMPA questionnaire CMPA questionnaire
Gibbons, 2012 Case-control: infants < 2 years seen at gastroenterology clinic with a diagnosis of CMPA & presumed healthy controls seen at routine health visit ROC-determined: score > 6 Health professional Elimination diet + ImmunoCAP Positive response to diet + test negative for IgE mediated disease + failed management of alternative conditions
CoMiSSTM (or its earlier SBS version) CoMiSSTM (or its earlier SBS version) CoMiSSTM (or its earlier SBS version) CoMiSSTM (or its earlier SBS version) CoMiSSTM (or its earlier SBS version) CoMiSSTM (or its earlier SBS version)
Prasad, 2018 Infants aged 0-24 months seen at paediatric clinic with one or more symptoms of CMPA, including cutaneous, respiratory, or GI Pre-specified: score > 12 General paediatrician OFC or ImmunoCAP Positive if symptoms reappear within 2 weeks of OFC or IgE mediated CMPA confirmed by ImmunoCAP
Salvatore, 2019
Case-control: infants aged 1-12 months seen at gastroenterology clinic with suspected CMPA and who started CMFD for persistent GI symptoms & healthy controls
Pre-specified: score > 12; ROC-determined: score > 9
Paediatrician
Response to CMFD
Change in CoMiSSTM score of symptomatic infants at presentation to a score below the median of control population after 2-4 weeks CMFD
Sirin Kose, 2019 Infants aged 0-10 months with a diagnosis of CMPA or HEA or both presenting to paediatric allergy clinic and with SBS > 12 Pre-specified: score > 12 with reduction of 25% or score > 10 with reduction of 50% Medical supervision OFC or skin prick test in infants < 6 months Positive if symptoms reoccur following OFC, positive skin prick with wheal >3mm
Vandenplas, 2014 Infants aged 0-6 months presenting with symptoms of mild to moderate CMPA and with SBS > 12 ROC-determined: score > 12 baseline to score < 6 after elimination Physician OFC Positive if symptoms reoccur within 1 week of OFC
Zeng, 2019 Infants aged 1-12 months seen at paediatric GI clinic for suspected CMPA with at least one symptom, including anaphylaxis, GI, respiratory and dermatological manifestations, and sIgE < 5.0 kU/L ROC-determined: score > 5.5 GI physician OFC Positive if symptoms reappear within 2 weeks of OFC
CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score CMFD – cow’s milk free diet CMPA – cow’s milk protein allergy HEA – hen’s egg allergy GI – gastrointestinal OFC – oral food challenge ROC – receiver operating curve sIgE – serum IgE SBS – symptom-based score