The CoMiSS Awareness Tool
The CoMiSS Awareness Tool
PURPOSE
The CoMiSSTM is a simple, fast and easy-to-use awareness tool for non-IgE mediated cows' milk-related symptoms. It increases awareness of the most common symptoms of cows' milk allergy (CMA) that in turn can aid an earlier diagnosis. CoMiSSTM can also be used to evaluate and quantify the evolution of symptoms during a therapeutic intervention.
THE CoMiSSTM SCORING
The CoMiSSTM 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 CMA. 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 extensiviley hydrolysed formula.
CoMiSSTM is not a diagnostic tool. CMA diagnosis can only be confirmed by an elimination diet followed by an oral food challenge.
THE CoMiSSTM SCORING FORM
Now rate the observed/reported symptoms by choosing the most appropriate score for each type of symptom or download the blank scoring form.
DownloadCoMiSS: Cow’s Milk-related Symptom Score
| Last name | First name | |
| Age | Date | |
PURPOSE
The CoMiSSTM is a simple, fast and easy-to-use awareness tool for non-IgE mediated cows' milk-related symptoms. It increases awareness of the most common symptoms of cows' milk allergy (CMA) that in turn can aid an earlier diagnosis. CoMiSSTM can also be used to evaluate and quantify the evolution of symptoms during a therapeutic intervention.
| Symptom | Score | |
|---|---|---|
| Crying |
Text Answer
|
0
|
| Regurgitation |
Text Answer
|
0
|
| Stools (Bristol scale) |
Text Answer
|
0
|
| Atopic eczema: Head, neck and trunk |
Text Answer
|
0
|
| Atopic eczema: Arms, hands, legs and feet |
Text Answer
|
0
|
| Urticaria |
Text Answer
|
0
|
| Respiratory symptoms |
Text Answer
|
0
|
| Final result | 0 | |
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
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