The CoMiSS is a simple, fast and easy-to-use awareness tool for cow’s milk-related symptoms. It increases awareness of the most common symptoms of cow’s milk protein allergy (CMPA) that in turn can aid an earlier diagnosis. CoMiSS can also be used to evaluate and quantify the evolution of symptoms during a therapeutic intervention.
The CoMiSS score ranges from 0 to 33.
Each symptom has a maximal score of six, with the exception of respiratory symptoms (maximal score of three).
An arbitrary cut-off value of ≥12 was selected as the criterion to pick up infants at risk of CMPA. A score of 12 requires the presence of at least two severe symptoms and a score higher than 12 requires the presence of at least three symptoms and the involvement of two organ systems.
Published data using the CoMiSS in clinical trials show that the predictive value of the tool is 80% if the score is >12 at the start and decreases to < 6 within 2 weeks under an elimination diet with an extensivley hydrolysed formula.
* Crying only considered if the child has been crying for 1 week or more, assessed by the parents, without any other obvious cause.
READING THE RESULT
The scoring ranges from 0 to 33. Each symptom has a maximal score of 6, except respiratory symptoms where the maximal score is 3.
If final score ≥ 12, the symptoms are likely cow’s milk related. This could potentially be CMPA.
If final score <12, the symptoms are less likely related to cow’s milk. Look for other causes.
CMPA diagnosis can only be confirmed by an elimination diet followed by an oral food challenge.
Vandenplas, Y., Dupont, C., Eigenmann, P., Host, A., Kuitunen, M., Ribes-Koninck, C., Shah, N., Shamir, R., Staiano, A., Szajewska, H. and Von Berg, A. (2015), A workshop report on the development of the Cow’s Milk-related Symptom Score awareness tool for young children. Acta Paediatrica. doi: 10.1111/apa.12902
© 2015 Nestlé Health Science