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Open AccessArticle

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

1
KidZ Health Castle, UZ Brussel, Brussels, Vrije Universiteit Brussel, 1090 Brussels, Belgium
2
Department of Paediatrics, Hospital Casa de Salud, 46021 Valencia, Spain
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Aalsters Stedelijk Ziekenhuis, 9300 Aalst, Belgium
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Department of Pediatric Gastroenterology, Hepatology and Nutrition, La Fe University Hospital, 46026 Valencia, Spain
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Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(2), 438; https://doi.org/10.3390/nu12020438
Received: 7 January 2020 / Revised: 6 February 2020 / Accepted: 7 February 2020 / Published: 9 February 2020
(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology )
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. View Full-Text
Keywords: Cow’s Milk-related Symptom Score; CoMiSS; infant Cow’s Milk-related Symptom Score; CoMiSS; infant
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Vandenplas, Y.; Carvajal, E.; Peeters, S.; Balduck, N.; Jaddioui, Y.; Ribes-Koninckx, C.; Huysentruyt, K. The Cow’s Milk-Related Symptom Score (CoMiSSTM): Health Care Professional and Parent and Day-to-Day Variability. Nutrients 2020, 12, 438.

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