Classification of the reactions
In the group of patients who experienced anaphylaxis during the OFC, more than three quarters of patients (76.2%) were classified as grade 2 according to the ICD-11 classification, and 34 patients (23.8%) were classified as grade 3. Distribution of patients according to the severity of the reaction, based on the different classification is shown in Table 3.
When comparing the different classifications, a complete concordance between all 5 of them, as for severity grading, was recorded in 8 patients (5.6%) only. Differences between classifications are shown in the Supplementary Table 1.
The sensitivity and specificity of the different classifications, for identifying anaphylaxis are shown in Table 4: sensitivity resulted the best for the classification of Muraro, Sampson, and Blazowski (100%), while specificity was the best for the one of Muraro (93.5%).
The determination of the area under the curve (AUC) showed that all classifications had a good ability to detect anaphylaxis. In the ROC analysis, the AUCs of CoFAR, Muraro’s, Blazowski’s and Sampson’s classifications were 0.83, 0.97, 0,95 and 0.93, respectively. The DeLong test showed a significant difference between the AUCs of the ICD-11 classification and those of CoFAR (p-value 0.0001), Muraro (p-value 0.0117) and Sampson (p-value 0.001) classifications.