6243 Development of a clinical predictive score for allergic reactions during oral food challenges in pediatric patients

Objectives The gold standard for diagnosing food allergy in children is the oral food challenge (OFC). However, OFCs are risky procedures. Forecasting allergic reactions during OFC according to potential risk factors has a great clinical value, Objective of this study is to develop a clinical predictive score for allergic reactions in pediatrics patients who undergoing OFCs. Methods A multivariable predictive model was developed using a database of patients performing OFCs during January 2014 to December 2022. Baseline demographics, allergy testing and allergic reactions during OFC were collected. The model was developed using logistic regression analysis. Predictor selection was conducted using a backward stepwise approach. Three risk groups were considered. Model performance was evaluated by area under the receiver operating characteristic curve, calibration, and classification measures. Results Our study involved 214 patients who undertook OFCs. Among these, 25 patients (11.7%) had allergic reactions during OFCs, with 4 patients (2.0%) developing anaphylaxis. The predictors were age, sex, allergic manifestation, family history of allergy and allergy testing. The model had an area under the receiver operating characteristic curve of 0.76. The range of predictive scores was 0 to 14. Patients were classified into two risk groups: low (score 0–4), and high (score 5–14). The allergic reactions during OFCs were reported 0% in low score group and 14.3% in high score group. Conclusion Our predictive score had good predictive ability to predict allergic reactions during an OFC. References Audrey DunnGalvin, et al. Highly accurate prediction of food challenge outcome using routinely available clinical data. Antonella Cianferoni, et al. Predictive values for food challenge-induced severe reactions: development of a simple food challenge score.