Arasi, StefaniaNurmatov, UlugbekDunn-Galvin, AudreyRoberts, GrahamTurner, Paul J.Shinder, Sayantani B.Gupta, RuchiEigenmann, PhilippeNowak-Wegrzyn, AnnaAnsotegui, Ignacio J.Rivas, Montserrat FernandezPetrou, StavrosTanno, Luciana K.Vazquez-Ortiz, MartaVickery, BrianWong, GaryAlvaro-Lozano, MontserratAsaria, MiqdadBegin, PhilippeBozzola, MartinBoyle, RobertBrough, HelenCardona, VictoriaChinthrajah, R. SharonCianferoni, AntonellaDeschildre, AntoineFleischer, DavidGazzani, FlavioGerdts, JenniferGiannetti, MarilenaGreenhawt, MatthewGuzmán, Maria AntonietaHossny, ElhamKauppi, PaulaJones, CarlaLucidi, FrancescoMonge Ortega, Olga PatriciaMunblit, DanielMuraro, AntonellaPajno, GiovanniPodestà, MarciaRodriguez del Rio, PabloSaid, MariaSantos, AlexandraShaker, MarcusSzajewska, HaniaVenter, CarinaWarren, CristopherWinders, TonyaEbisawa, MotohiroFiocchi, Alessandro2024-02-152024-02-152023-03Arasi, S, Nurmatov, U, Dunn-Galvin, A, Roberts, G, Turner, P J, Shinder, S B, Gupta, R, Eigenmann, P, Nowak-Wegrzyn, A, Ansotegui, I J, Rivas, M F, Petrou, S, Tanno, L K, Vazquez-Ortiz, M, Vickery, B, Wong, G, Alvaro-Lozano, M, Asaria, M, Begin, P, Bozzola, M, Boyle, R, Brough, H, Cardona, V, Chinthrajah, R S, Cianferoni, A, Deschildre, A, Fleischer, D, Gazzani, F, Gerdts, J, Giannetti, M, Greenhawt, M, Guzmán, M A, Hossny, E, Kauppi, P, Jones, C, Lucidi, F, Monge Ortega, O P, Munblit, D, Muraro, A, Pajno, G, Podestà, M, Rodriguez del Rio, P, Said, M, Santos, A, Shaker, M, Szajewska, H, Venter, C, Warren, C, Winders, T, Ebisawa, M & Fiocchi, A 2023, 'WAO consensus on DEfinition of Food Allergy SEverity (DEFASE)', World Allergy Organization journal, vol. 16, no. 3, 100753. https://doi.org/10.1016/j.waojou.2023.100753ORCID: /0000-0002-1065-330X/work/159452482http://hdl.handle.net/10138/571291Background: While several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole. Aim: To develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally. Methods: Phase 1: We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts. Phase 2: Based on our findings in Phase 1, we drafted statements for a two-round modified electronic Delphi (e-Delphi) survey. A purposefully selected multidisciplinary international expert panel on food allergy (n = 60) was identified and sent a structured questionnaire, including a set of statements on different domains of food allergy severity related to symptoms, health-related quality of life, and economic impact. Participants were asked to score their agreement on each statement on a 5-point Likert scale ranging from “strongly agree” to “strongly disagree”. Median scores and percentage agreements were calculated. Consensus was defined a priori as being achieved if 70% or more of panel members rated a statement as “strongly agree” to “agree” after the second round. Based on feedback, 2 additional online voting rounds were conducted. Results: We received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score. Conclusions: The DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.23engcc_by_nc_ndinfo:eu-repo/semantics/openAccessConsensusDefinitione-Delphi studyFood allergySeverityGeneral medicine, internal medicine and other clinical medicineArticleopenAccessb47827e9-8e98-46f0-b92c-eda2af21d66b000989412800001