{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T23:03:33Z","timestamp":1778713413906,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR301454"],"award-info":[{"award-number":["NIHR301454"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Many patients are labelled incorrectly as \u2018penicillin allergic\u2019. This label is associated with poor health outcomes, regardless of whether the allergy is genuine. We designed a study to assess agreement between allergy specialists (consultant allergists or immunologists) and non\u2010allergists when using a risk stratification tool to determine suitability for a penicillin challenge test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this two\u2010centre mixed\u2010method study, adult patients undergoing surgery who had been labelled penicillin allergic were assessed by a healthcare professional with no formal allergy training (consultant anaesthetist or peri\u2010operative nurse) and an allergy specialist doctor using the risk stratification tool. Cohen's kappa was used to quantify agreement. We conducted a qualitative process evaluation based on individual and group interviews to explore user experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recruited 139 patients and 11 healthcare professionals; 101 patients completed both assessments (median (IQR [range]) age was 53 (40\u201366 [19\u201386]) y, 71% women). Allergist and non\u2010allergist assessments agreed for 63 (62%) patients. In the remaining 38 (38%), most disagreements represented an overcautious approach by non\u2010allergists, except in seven patients categorised as unsuitable (or uncertain) by the allergist but suitable by the non\u2010allergist. Inter\u2010rater agreement was moderate (unweighted \u03ba 0.43, 95%CI 0.30\u20130.57; weighted \u03ba 0.47, 95%CI 0.27\u20130.67). The prevalence and bias\u2010adjusted score indicated poor inter\u2010rater reliability (\u03ba score 0.25, 95%CI 0.06\u20130.44). Qualitative analysis indicated low confidence in the tool among non\u2010allergists, with a perceived need for allergy training and specialist support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This penicillin allergy risk stratification tool, designed for use by healthcare professionals with no formal allergy training, showed poor agreement with allergy expert assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16758","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:47:02Z","timestamp":1757918822000},"page":"222-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Penicillin allergy risk stratification tool for use by non\u2010allergists in the peri\u2010operative setting: an agreement study and qualitative process evaluation"],"prefix":"10.1111","volume":"81","author":[{"given":"Priyanthi","family":"Dias","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Walshaw","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Flatau","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen","family":"O'Grady","sequence":"additional","affiliation":[{"name":"Department of Immunology Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M.","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research University of Leeds  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lene Heise","family":"Garvey","sequence":"additional","affiliation":[{"name":"Department of Clinical medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Littlejohns","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikki","family":"Rousseau","sequence":"additional","affiliation":[{"name":"Leeds Institute of Clinical Trials Research University of Leeds  Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupert M.","family":"Pearse","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany","family":"Shinkins","sequence":"additional","affiliation":[{"name":"Warwick Applied Health, Warwick Medical School Warwick University  Coventry UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-2288","authenticated-orcid":false,"given":"Louise","family":"Savic","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Leeds Teaching Hospitals NHS Trust  Leeds 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