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Stinging Insect Hypersensitivity a Practice Parameter Update 2016 David B.K

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Stinging Insect Hypersensitivity a Practice Parameter Update 2016 David B.K Ann Allergy Asthma Immunol 118 (2017) 28e54 Contents lists available at ScienceDirect Practice Parameter Stinging insect hypersensitivity A practice parameter update 2016 David B.K. Golden, MD; Jeffrey Demain, MD; Theodore Freeman, MD; David Graft, MD; Michael Tankersley, MD; James Tracy, DO; Joann Blessing-Moore, MD; David Bernstein, MD; Chitra Dinakar, MD; Matthew Greenhawt, MD; David Khan, MD; David Lang, MD; Richard Nicklas, MD; John Oppenheimer, MD; Jay Portnoy, MD; Christopher Randolph, MD; Diane Schuller, MD; Dana Wallace, MD ARTICLE INFO Article history: Received for publication October 26, 2016. Accepted for publication October 31, 2016. Reprints: David B. K. Golden, MD, Department of Medicine, Johns Hopkins University School of Medicine, 7939 Honeygo Blvd, Suite 219, Baltimore, MD 21236; E-mail: [email protected]. Disclaimer: The American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI) have jointly accepted responsibility for establishing “Stinging Insect Hypersensitivity: a practice parameter update 2016.” This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI or the ACAAI. These parameters are not designed for use by pharmaceutical companies in drug promotion. Disclosures: The following is a summary of interests disclosed on Work Group members’ Conflict of Interest Disclosure Statements (not including information concerning family member interests). Completed Conflict of Interest Disclosure Statements are available upon request. Conflicts of interest disclosure statements for JTF are available on its website. Dr Golden has served on the speaker’s bureau and clinical trials for Genentech, has served on the speaker’s bureau for Stallergenes/Greer, has served as an expert witness for & Trifrolis, PC, and is a section editor for UptoDate. Dr Demain is a contributor to UptoDate. Dr Graft is an author for UptoDate. Dr Tracy is a contributor to UptoDate. The other Work Group members have nothing to disclose. The Joint Task Force recognizes that experts in a field are likely to have interests that could come into conflict with development of a completely unbiased and objective practice parameter. To take advantage of that expertise, a process has been developed to prevent potential conflicts from influencing the final document in a negative way. At the workgroup level, members who have a potential conflict of interest either do not participate in discussions concerning topics related to the potential conflict or if they do write a section on that topic, the workgroup completely rewrites it without their involvement to remove potential bias. In addition, the entire document is reviewed by the Joint Task Force and any apparent bias is removed at that level. Finally, the practice parameter is sent for review both by invited reviewers and by anyone with an interest in the topic by posting the document on the web sites of the ACAAI and the AAAAI. Chief Editor: David B. K. Golden, MD Practice Parameter Work Group: David B.K. Golden, MD, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Jeffrey Demain, MD, Allergy, Asthma & Immunology Center of Alaska, University of Washington, and University of Alaska, Anchorage, Alaska; Theodore Freeman, MD, San Antonio Asthma and Allergy Clinic, San Antonio, Texas; David Graft, MD, Asthma and Allergic Diseases, Park Nicollet Clinic, and Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota; Michael Tankersley, MD, University of Tennessee Health Science Center, Memphis, Tennessee; James Tracy, DO, Department of Pediatrics, University of Nebraska College of Medicine, and Allergy, Asthma and Immunology Associates, Omaha, Nebraska; and Joanne Blessing-Moore, MD, Department of Immunology, Stanford University Medical Center, Palo Alto, California. Members of the Joint Task Force on Practice Parameters: David Bernstein, MD, Department of Clinical Medicine and Environmental Health, Division of Allergy/Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio; Joann Blessing-Moore, MD, Department of Immunology, Stanford University Medical Center, Palo Alto, California; Chitra Dinakar, MD, Department of Pediatrics, University of Missouri-Kansas City, and Division of Allergy, Asthma and Immunology, FAE Center of Excellence, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri; Matthew Greenhawt, MD, Allergy Section, Children’s Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colorado; David Khan, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; David Lang, MD, Department of Allergy and Clinical Immunology and Asthma Center, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio; Richard Nicklas, MD, Department of Medicine, George Washington Medical Center, Washington, DC; John Oppenheimer, MD, Department of Internal Medicine, New Jersey Medical School, Pulmonary and Allergy Associates, Morristown, New Jersey; Jay Portnoy, MD, Section of Allergy, Asthma & Immunology, The Children’s Mercy Hospital, and Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Christopher Randolph, MD, Department of Pediatrics, Yale Affiliated Hospitals, Center for Allergy, Asthma, & Immunology, Waterbury, Connecticut; Diane Schuller, MD, Department of Pediatrics, Pennsylvania State University Milton S. Hershey Medical College, Hershey, Pennsylvania; and Dana Wallace, MD, Department of Medicine, Nova Southeastern University College of Osteopathic Medicine, Davie, Florida. Invited Reviews (in alphabetical order): Wesley Burks, MD, Durham, North Carolina; Vivian Henrandez-Trujullo, Davie, Florida; Richard Lockey, MD, Tampa, Florida; Jonathan Matz, MD, Columbia, Maryland; Andrew Murphy, MD, Downingtown, Pennsylvania; Julie Wang, MD, New York, New York. All published practice parameters are available at http://www.allergyparameters.org/. The Joint Task Force has made a concerted effort to acknowledge all contributors to this parameter. If any contributors have been excluded inadvertently, the Task Force will ensure that appropriate recognition of such contributions is made subsequently. http://dx.doi.org/10.1016/j.anai.2016.10.031 1081-1206/Ó 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. D.B.K. Golden et al. / Ann Allergy Asthma Immunol 118 (2017) 28e54 29 Classification of Recommendations and Evidence MD, invited workgroup members to participate in the parameter development who are considered experts in the field. Work group Recommendation Rating Scale members have been vetted for financial conflicts of interest by the JTF, and their conflicts of interest have been listed in this document Category of Evidence and are posted on the JTF website at http://www. fl Ia Evidence from meta-analysis of randomized controlled trials allergyparameters.org. Where a potential con icts of interest is fl Ib Evidence from at least one randomized controlled trial present, the potentially con icted work group member was IIa Evidence from at least one controlled study without excluded from discussing relevant issues. The charge to the work randomization group was to use a systematic literature review, in conjunction with fi IIb Evidence from at least one other type of quasi-experimental consensus expert opinion and workgroup-identi ed supplemen- study tary documents, to develop a Practice Parameter that provides a III Evidence from non-experimental descriptive studies, such as comprehensive approach for insect hypersensitivity based on the comparative studies current state of the science. IV Evidence from expert committee reports or opinions or clinical experience of respected authorities or both Protocol for Finding Evidence A search of the medical literature was performed using a variety Strength of Recommendation* of terms that were considered relevant for this practice parameter. Literature searches were performed on PubMed, MEDLINE, Med- A Directly based on category I evidence scape, Google Scholar, and the Cochrane Database of Systematic B Directly based on category II evidence or extrapolated Reviews. The time frame for most searches was 2011 to 2016, but recommendation from category I evidence some topics required searches for an expanded timeframe from C Directly based on category III evidence or extrapolated 1960 to present. The searches included only English-language recommendation from category I or II evidence articles. D Directly based on category IV evidence or extrapolated Search terms included insect venom, Hymenoptera venom, insect recommendation from category I, II, or III evidence sting, venom immunotherapy, venom skin tests, venom diagnostic LB Laboratory Based tests, serum tryptase, mastocytosis, angiotensin-converting enzyme NR Not rated inhibitors (ACEIs), b-blockers, basophil activation tests, recombinant venom allergens, venom component tests, fire ant, stinging
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