The following is a summary of “Cow’s Milk-Related Symptom Score (CoMiSS): From Bristol to Brussels Stool Scale,” published in the November 2023 issue of Pediatrics by Bajerova, et al.

For a study, researchers sought to assess whether substituting the Bristol Stool Form Scale (BSFS) with the Brussels Infants and Toddlers Stool Scale (BITSS) in non-toilet-trained infants would alter the overall Cow’s Milk-related Symptom Score (CoMiSS) and influence the clinical approach to potential cow’s milk allergy.

Non-toilet-trained infants under 13 months were evaluated using CoMiSS with the 7 images from the BSFS (CoMiSS-BSFS) and compared to the 4 images of stools from BITSS (CoMiSS-BITSS). Statistical analyses were conducted, including the Wilcoxon signed-rank test and Pearson correlation coefficient. Post hoc analyses were performed on subsets of CoMiSS-BSFS scores (≥10, ≥12, ≤5, and ≥6).

A total of 844 pairwise scores were collected. The Wilcoxon test over the complete dataset indicated a statistically significant difference between CoMiSS-BSFS and CoMiSS-BITSS (P < 0.001). However, no significant difference was observed in subsets with CoMiSS-BSFS ≥10, ≥12, and ≥6 (P = 0.84, P = 0.48, and P = 0.81, respectively). The significant difference was confined to the group with CoMiSS-BSFS ≤5, representing a low risk for cow’s milk-related symptoms (P < 0.001).

Substituting BSFS with BITSS does not alter the cutoff for awareness of potential cow’s milk-related symptoms and does not impact the use of CoMiSS in clinical practice. Changes in CoMiSS scores were limited to the subgroup with a low risk for cow’s milk-related symptoms.

Source: journals.lww.com/jpgn/fulltext/2023/11000/cow_s_milk_related_symptom_score__comiss___from.10.aspx