Cow’s Milk-related Symptom Score for cow’s milk allergy assessment: a meta-analysis for test accuracy

Abstract

Background: We aimed to assess the ability of Cow’s Milk-related Symptom Score (CoMiss) in screening cow’s milk protein allergy (CMPA) and assess validation of its sensitivity and specificity. Methods: We searched the PubMed, WOS, Embase, and Ovid databases using broad terms and keywords for the concepts of the symptom-based score (CoMiss) and cow’s milk allergy. We performed the meta-analyses using a meta-package of R software and Meta-DiSc software. Results: Fourteen studies were included with a total of 1238 children. At cut-off value 12, CoMiss had a pooled sensitivity of 0.64 and a pooled specificity of 0.75. The PLR and NLR were 3.05 and 0.5, respectively. The AUC value of the sROC curve was 0.7866. CoMiss showed a significant difference in CMPA patients at baseline and after milk elimination for 2–4 weeks (MD, 7.18), as well as between the CMPA-positive group compared with the CMPA-negative group, however, the statistical significancy was obtained after leave study of Selbuz et al. out of the analysis (MD, 4.61). Conclusions: CoMiss may be a promising symptom score in the Awareness of the symptoms related to cow’s milk allergy and a useful tool in monitoring the response to a cow’s milk-free diet. Impact: Cow’s milk protein allergy (CMPA) is the most frequent food allergy in children under the age of 3 years. Cow’s Milk-related Symptom Score (CoMiss) is a clinical scoring system to assist primary healthcare providers in early detection of CMPAWe performed a meta-analysis of CoMiss test accuracy.Our findings reflect that CoMiss may be a promising symptom score in CMPA awareness and a useful tool in monitoring the response to a cow’s milk-free diet.