KidZ Health Castle, UZ Brussel, Brussels, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
Department of Paediatrics, Hospital Casa de Salud, 46021 Valencia, Spain.
Nutrients. 2020 Feb 9;12(2):438. doi: 10.3390/nu12020438.
The Cow's Milk-related Symptom Score (CoMiSS) 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, < 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; < 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.
牛奶相关症状评分（CoMiSS）是作为牛奶过敏的一种意识工具而创建的。本研究的目的是分析儿科医生、父母之间的评分者间变异性以及日常变异性。医疗保健专业人员（HCP）和父母独立填写 CoMiSS，彼此之间为盲法，以评估评分者间的变异性。为了验证日常变异性，父母连续 3 天填写 CoMiSS，并与 HCP 评分进行比较。父母和 HCP 之间的绝对一致性为 75%，在 0、1 和 2 分的容忍度下，分别为 92.6%和 100%，具有极好的一致性，组内相关系数（ICC）为 0.981（95%置信区间 0.974-0.986，<0.001）。连续 3 天的日常变异性导致绝对一致性为 30%，当分别接受 2 分和 3 分时，增加至 80%和 88.6%。父母前瞻性评分的 ICC 非常好（0.93，95%CI 0.90-0.96；<0.001）。日常变异性表明 CoMiSS 的评分者间可靠性中等。当连续 3 天前瞻性评分时，观察到的变异性非常低。数据表明，无需额外培训，父母可以可靠地对 CoMiSS 进行评分。
