A Qualitative Study Evaluating the Parent-Specific Cow's Milk-Related Symptom Score (Pre-CoMiSS™)

Background/Objectives: Cow's milk allergy (CMA) is one of the most frequent food allergies in early childhood, yet its diagnosis remains a challenge. The Parent-Specific Cow's Milk-Related Symptom Score (Pre-CoMiSS™) was developed in 2024 to assist parents in tracking possible cow's milk-related symptoms in their infants. The aim of this qualitative study was to explore users' experience with the Pre-CoMiSS™ tool, learn from their experience and identify areas for improvement. Methods: Participants were parents of infants aged up to 12 months who felt that their babies were experiencing possible feeding-related symptoms. Participants were selected from a local panel of potential parents in the UK and Sweden. Forty-five-minute interviews, led by experienced qualitative research moderators, were conducted using dedicated discussion guides and a frame-by-frame PDF version of the Pre-CoMiSS™ tool. Thematic analysis of the data was undertaken. Results: A total of 20 parents participated, 10 from the UK and 10 from Sweden. The Pre-CoMiSS™ tool was well received by parents from both countries. Parents found the tool's results clear, useful, and easy to understand. However, some parents, especially from Sweden, expressed the need for additional guidance on next steps. Conclusions: Parents found the Pre-CoMiSS™ tool acceptable and easy to use, although some requested clearer guidance on next steps. These findings support further refinement and formal validation before clinical implementation.