Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report—a GA2LEN project
Bibliographic record
Abstract
BACKGROUND: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes. OBJECTIVE: We sought to develop a consensus anaphylaxis definition, overview, and clinical support tool. METHODS: A 12-member writing group developed draft outputs modified with input from a 46-member international expert panel, 31 medical stakeholder organizations, and 15 patient advocacy organizations. The expert panel participated in a modified Delphi process to seek consensus for the outputs using a ≥80% consensus threshold. RESULTS: The first sentence of the definition reads, "Anaphylaxis is a serious allergic (hypersensitivity) reaction that can progress rapidly and may cause death." The definition also describes organ systems that may be involved and signs of life-threatening reactions. The overview includes details of anaphylaxis recognition and management. The clinical support tool incorporates new clinical criteria to help determine the likelihood that patients are having anaphylaxis, intramuscular epinephrine indications and dosing, and common findings from the anaphylaxis organ systems. In addition, 93.5% (43/46), 97.8% (45/46), and 93.5% (43/46) of experts agreed with the definition, overview, and clinical support tool, respectively. CONCLUSION: The anaphylaxis overview is a novel educational tool conveying key elements of anaphylaxis recognition and management. We propose that the definition and clinical support tool should replace previous definitions and clinical criteria. The clinical support tool should facilitate improved anaphylaxis recognition and management across different clinical settings and standardize research outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.261 | 0.226 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.007 | 0.004 |
| Open science | 0.006 | 0.013 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.013 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".