Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2025
Development of a validated, updated North American pediatric food allergy anaphylaxis management plan.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Anagnostou Aikaterini, Abrams Elissa M, Anderson William C, Carver Melanie, Eftekhari Sanaz, Golden David B K, Jaffee Hannah, Lieberman Jay A, Mack Douglas P, Mustafa S Shahzad, Shaker Marcus S, Spergel Jonathan M, Stukus David R, Wang Julie, Greenhawt Matthew
Аннотация
BACKGROUND: Current North American anaphylaxis action plans (AAPs) lack updated anaphylaxis guidelines that conditionally recommend "immediate activation of emergency medical services" after epinephrine use for patients experiencing a "prompt, complete, and durable response" to treatment. This offers a contextualized "watchful waiting" approach. AAPs may not include newly approved nasal epinephrine or differentiate anaphylaxis presentations by age.
OBJECTIVE: To develop an updated AAP.
METHODS: A prototype AAP was iteratively developed incorporating a "watchful waiting" approach, the nasal epinephrine option, and age-specific anaphylaxis symptom presentations among a team of anaphylaxis experts and patient and advocacy stakeholders to assess medical accuracy, readability, clarity, and bias. This underwent validated assessment of decisional acceptability, decisional conflict, and decisional self-efficacy in a sample of stakeholders with children at risk for anaphylaxis, or at risk themselves.
RESULTS: We developed a 2-page written plan (Flesch-Kincaid reading level 5.9) explaining management choices for severe and nonsevere reactions, indications for watchful waiting vs emergency medical services activation after epinephrine use, updated medication options, and age-based symptom differentiation. A total of 229 stakeholders assessed the AAP, noting good acceptability, high decisional self-efficacy (mean score 86.2/100, SD 15.9), and moderate decisional conflict (mean score 43.7/100, SD 18.8). Decisional conflict was unrelated to past anaphylaxis or epinephrine use. Information content was clear and sufficiently explained options with balanced and without a "best choice" bias. Overall, 86% of the respondents would recommend using this AAP.
CONCLUSION: This is the first validated AAP incorporating preference-sensitive post-epinephrine management options consistent with updated North American guidelines, newly approved nasal epinephrine, and age-specific anaphylaxis presentation.
OBJECTIVE: To develop an updated AAP.
METHODS: A prototype AAP was iteratively developed incorporating a "watchful waiting" approach, the nasal epinephrine option, and age-specific anaphylaxis symptom presentations among a team of anaphylaxis experts and patient and advocacy stakeholders to assess medical accuracy, readability, clarity, and bias. This underwent validated assessment of decisional acceptability, decisional conflict, and decisional self-efficacy in a sample of stakeholders with children at risk for anaphylaxis, or at risk themselves.
RESULTS: We developed a 2-page written plan (Flesch-Kincaid reading level 5.9) explaining management choices for severe and nonsevere reactions, indications for watchful waiting vs emergency medical services activation after epinephrine use, updated medication options, and age-based symptom differentiation. A total of 229 stakeholders assessed the AAP, noting good acceptability, high decisional self-efficacy (mean score 86.2/100, SD 15.9), and moderate decisional conflict (mean score 43.7/100, SD 18.8). Decisional conflict was unrelated to past anaphylaxis or epinephrine use. Information content was clear and sufficiently explained options with balanced and without a "best choice" bias. Overall, 86% of the respondents would recommend using this AAP.
CONCLUSION: This is the first validated AAP incorporating preference-sensitive post-epinephrine management options consistent with updated North American guidelines, newly approved nasal epinephrine, and age-specific anaphylaxis presentation.