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Persistent, refractory, and biphasic anaphylaxis: A multidisciplinary Delphi study.

Timothy E Dribin1, Hugh A Sampson2, Carlos A Camargo3

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The Journal of Allergy and Clinical Immunology
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PubMed
Summary
This summary is machine-generated.

Standardized definitions for anaphylaxis outcomes were developed by experts using Delphi methodology. This consensus will improve understanding and research into anaphylaxis and related reactions.

Keywords:
AnaphylaxisDelphibiphasic anaphylaxisbiphasic nonanaphylactic reactionsemergency departmentpersistent anaphylaxispersistent nonanaphylactic reactionsrefractory anaphylaxis

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Area of Science:

  • Allergy and Immunology
  • Emergency Medicine
  • Clinical Research Methodology

Background:

  • Inconsistent definitions for anaphylaxis outcomes impede understanding of its natural history and epidemiology.
  • This lack of standardization hinders clinical practice and research efforts in anaphylaxis management.

Framework:

  • Utilized Delphi methodology with a multidisciplinary expert panel (allergists, immunologists, emergency medicine physicians).
  • Employed online surveys and iterative consensus-building to define key anaphylaxis outcomes.
  • Established clear criteria for consensus (median agreement) and disagreement indices.

Implementation:

  • Developed consensus definitions for persistent, refractory, and biphasic anaphylaxis.
  • Defined persistent and biphasic nonanaphylactic reactions.
  • Reached consensus on the necessity for an anaphylaxis severity grading system.

Implications:

  • Standardized terminology for anaphylaxis outcomes will enhance clinical care and research consistency.
  • These definitions provide a foundation for future research, including severity grading.
  • Widespread adoption will improve the understanding and management of anaphylaxis globally.