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. 2020 Feb 9;12(2):438.
doi: 10.3390/nu12020438.

The Cow's Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability

Yvan Vandenplas  1 , Eva Carvajal  2 , Stefaan Peeters  3 , Nadine Balduck  1 , Yesra Jaddioui  1 , Carmen Ribes-Koninckx  4 , Koen Huysentruyt  1   5
Affiliations

The Cow's Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability

Yvan Vandenplas et al. Nutrients. .

Abstract

The Cow's Milk-related Symptom Score (CoMiSSTM) was created as an awareness tool for cow's milk allergy. The aim of the present study was to analyze the inter-rater variability between a pediatrician, parents, and day to day variability. A Health Care Professional (HCP) and parent filled in the CoMiSS independently and blinded for each other to evaluate inter-rater variability. In order to validate day-to-day variability, a parent filled in the CoMiSS during 3 consecutive days and was compared to the CoMiSS scored by the HCP. The absolute agreement between parent and HCP was 75%, and 92.6% and 100% with a tolerance of 0, 1, and 2 points, respectively, resulting in excellent agreement with an intraclass correlation coefficient (ICC) 0.981 (95% Confidence Interval 0.974-0.986, p < 0.001). Day-to-day variability during 3 consecutive days resulted in an absolute agreement of 30%, increasing to 80% and 88.6% when 2 and 3 points, respectively, were accepted. The ICC was excellent for the parental prospective scores (0.93, 95% CI 0.90-0.96; p < 0.001). Day-to-day variability indicates that CoMiSS has a moderate inter-rater reliability. A very low variability was observed when scored prospectively over three days. Data suggest that the CoMiSS can reliably be scored by parents without additional training.

Keywords: CoMiSS; Cow’s Milk-related Symptom Score; infant.

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Conflict of interest statement

Y.V. has participated as a clinical investigator, and/or advisory board member, and/or consultant, and/or speaker for Abbott Nutrition, Biocodex, Danone, Nestle Health Science, Nestle Nutrition Institute, Nutricia, United Pharmaceuticals, Wyeth. CRK has participated as a consultant and/or speaker for Danone-Nutricia, Mead-Johnson, Nestle Nutrition Institute. The other authors report no COI.

Figures

Figure 1
Figure 1
Day to day variability in individual CoMiSS on three consecutive days by a parent.
See this image and copyright information in PMC

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