Background

Despite a better understanding of the epidemiology, pathogenesis, and management of patients with anaphylaxis, there remain knowledge gaps. Enumerating and prioritizing these gaps would allow limited scientific resources to be directed more effectively.

Objective

We sought to systematically describe and appraise anaphylaxis knowledge gaps and future research priorities based on their potential impact and feasibility.

Methods

We convened a 25-member multidisciplinary panel of anaphylaxis experts. Panelists formulated knowledge gaps/research priority statements in an anonymous electronic survey. Four anaphylaxis themed writing groups were formed to refine statements: (1) Population Science, (2) Basic and Translational Sciences, (3) Emergency Department Care/Acute Management, and (4) Long-Term Management Strategies and Prevention. Revised statements were incorporated into an anonymous electronic survey, and panelists were asked to rate the impact and feasibility of addressing statements on a continuous 0 to 100 scale.

Results

The panel generated 98 statements across the 4 anaphylaxis themes: Population Science (29), Basic and Translational Sciences (27), Emergency Department Care/Acute Management (24), and Long-Term Management Strategies and Prevention (18). Median scores for impact and feasibility ranged from 50.0 to 95.0 and from 40.0 to 90.0, respectively. Key statements based on median rating for impact/feasibility included the need to refine anaphylaxis diagnostic criteria, identify reliable diagnostic, predictive, and prognostic anaphylaxis bioassays, develop clinical prediction models to standardize postanaphylaxis observation periods and hospitalization criteria, and determine immunotherapy best practices.

Conclusions

We identified and systematically appraised anaphylaxis knowledge gaps and future research priorities. This study reinforces the need to harmonize scientific pursuits to optimize the outcomes of patients with and at risk of anaphylaxis.

中文翻译：

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过敏反应知识差距和未来研究重点：共识报告

背景

尽管对过敏反应患者的流行病学、发病机制和管理有了更好的了解，但仍存在知识空白。列举这些差距并确定优先次序将使有限的科学资源得到更有效的指导。

客观的

我们试图根据潜在影响和可行性系统地描述和评估过敏反应知识差距和未来的研究重点。

方法

我们召集了一个由 25 名成员组成的过敏反应专家多学科小组。小组成员在匿名电子调查中制定了知识差距/研究优先级声明。成立了四个过敏反应主题写作小组以完善陈述：(1) 人口科学，(2) 基础和转化科学，(3) 急诊科护理/急性管理，以及 (4) 长期管理策略和预防。修订后的陈述被纳入一项匿名电子调查，小组成员被要求以连续的 0 到 100 的比例对解决陈述的影响和可行性进行评分。

结果

该小组针对 4 个过敏反应主题生成了 98 份声明：人口科学 (29)、基础和转化科学 (27)、急诊科护理/急性管理 (24) 以及长期管理策略和预防 (18)。影响力和可行性的中值分数分别为 50.0 至 95.0 和 40.0 至 90.0。基于影响/可行性中值评级的关键陈述包括需要改进过敏反应诊断标准，确定可靠的诊断、预测和预后过敏反应生物测定，开发临床预测模型以标准化过敏反应后观察期和住院标准，并确定免疫治疗最佳实践。

结论

我们确定并系统地评估了过敏反应知识差距和未来的研究重点。这项研究强调了协调科学追求的必要性，以优化患有过敏反应和有过敏反应风险的患者的预后。