Mobile application-guided open oral food challenge used in infants with
non-IgE mediated cow's milk protein allergy during COVID-19 pandemic
Background: Open oral food challenge (OFC) is a useful tool in
management of non-IgE mediated cow’s milk allergy (CMPA) infants.
Because of COVID-19 pandemic, clinical services for noninfectious
diseases were hard to maintain as usual. Internet hospital model of
medicine got more profoundly involved in the medical service systems.
Methods:we used a hospital-led mobile application (APP) platform to
guide the open OFC conducted at home, and assessed the effect of this
novel model by comparing with the traditional pattern of open OFCs.
Results:Sixty two infants with aged 6.552.81 months were included.
Result of Kappa coefficient was 0.596 (P=0.000) suggesting a good
consistency of judgments between parents and doctors in APP-guided
group. The accuracy of parents was 85.48% and 74.36% in APP-guided
group and control group, respectively. If parents reported positive
results, the consistency with outcomes confirmed by specialists was
87.76% and 74.51%, while If parents reported no symptoms, the rate of
negative outcomes identified by specialist was 76.92% and 74.07% in
two groups. With the utilization of mobile application, the
false-positive rate (12.25%) was reduced by half with statistical
significance (Χ2=39.32, P=0.000). The proportion of false-positive
caused by vomiting decreased from 61.5% (8/13) to 33.33% (2/6).
Conclusion: This was a preliminary attempt to use hospital-led
telemedicine tool for guiding open OFCs in CMPA children. Although there
are still many problems needing discussion, it could be a promising
approach used in pediatric population with allergic diseases during the
special period like COVID-19 pandemic.