{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:33:58Z","timestamp":1785227638336,"version":"3.55.0"},"reference-count":51,"publisher":"Oceanside Publications Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Drug provocation test (DPT) without skin tests is increasingly recommended in the evaluation of children with low-risk beta-lactam (BL) allergies. However, risk definitions are unclear.  <jats:bold>Objective:<\/jats:bold> The aim of this study was to compose a clinical\n predictive model that could identify the children at low risk who could safely undergo direct DPT.  <jats:bold>Methods:<\/jats:bold> The clinical data of 204 children who underwent a full diagnostic algorithm for suspected BL allergy were analyzed. Clinical data were used to construct mathematical\n predictive model for confirmed BL allergies. A prospective new sample was used for external validation of the final model.  <jats:bold>Results:<\/jats:bold> The presentations during the index reaction were anaphylaxis in 5.9% and cutaneous reactions in the majority. BL allergy was confirmed in\n 15.7% of suspected cases. A backward multiple logistic regression model showed that a family history of drug allergy (adjusted odds ratio [aOR], 5.52), anaphylaxis (aOR, 5.14), any atopic disease other than asthma (aOR, 4.38), and a reaction interval of 0\u20106 hours during the index reaction\n (aOR, 5.32) were significantly associated with a confirmed BL allergy. A mathematical combined model based on these factors showed a sensitivity of 77.8% and a negative predictive value (NPV) of 94.3%. The validation study replicated sensitivity and NPV values of the main cohort. \n <jats:bold>Conclusion:<\/jats:bold> The risk definition in BL allergies should depend on population-specific predictive models, including a combination of significant risk factors rather than empiric risk approaches. This may help to accurately determinate children at low risk who may safely proceed to\n direct DPT.<\/jats:p>","DOI":"10.2500\/aap.2021.42.210068","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T20:07:14Z","timestamp":1638821234000},"page":"e159-e166","source":"Crossref","is-referenced-by-count":9,"title":["A combined risk modeling strategy for clinical prediction of beta-lactam allergies in children"],"prefix":"10.2500","volume":"42","author":[{"given":"Ali","family":"Demirhan","sequence":"first","affiliation":[{"name":"From the Department of Pediatric Allergy and Clinical Immunology, Faculty of Medicine, Mersin University, Mersin, Turkey, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didem D.","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, Mersin, 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