Validation of a modified cow's milk-related symptom score (CoMISS) for screening of lactose intolerance in adults

Heba Ibrahim Mohammed (1), Essam Baioumy (2), Mohamed Farouk Allam (1), Mohamed Nabil Badawy Al-Ashram (2)

 

1. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2. Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

 

DOI: 10.1080/03007995.2022.2057153

 

Abstract

Introduction: Lactose intolerance (LI) is the failure to digest foods and beverages containing the lactose present in milk. LI can present by many digestive symptoms.

Objective: To validate the modified CoMiSS score for prediction of LI, that was confirmed by a stool acidity test.

Patients and methods: A cross-sectional study, was conducted at Ain Shams University Hospitals/Gastrointestinal Clinics, and included one hundred adult participants during the period from December 2018 to December 2019. Enrolled patients had one or more gastrointestinal symptoms and were subjected to a stool acidity test (fecal PH test) as a reference test and modified CoMiSS as an index test. 

Results: The mean age of participants was 35.30 ± 10.714 years old; 55% were females, and their mean body mass index (BMI) was 23.08 ± 2.080 kg/m2, with no significant relation between LI and patients` gender or BMI. Out of the studied participants 24% had positive stool PH, LI diagnosed according to modified CoMISS was present among 19% of them. The mean value of modified CoMISS Score was significantly higher in positive cases (12.37) compared to negative LI participants (2.33) as p < 0.001. Area under ROC Curve was 0.998, at the selected cut-off value 8, the sensitivity was 89.5% and specificity was 100% thus, levels of questionnaire scoring of 8 or higher would indicate presence of lactose intolerance. 

Conclusion: Modified CoMiSS is a simple, fast, and easy-to-use tool that can predict LI, with a cut-off value of >8, the Area under the ROC Curve was 0.998, sensitivity 89.5%, and specificity was 100%.

Keywords: Adults; LI; Modified CoMISS Score; Sensitivity; Specificity; Validity.

 

Current Medical Research and Opinion 2022 Mar 23;1-19.

 

https://www.tandfonline.com/doi/full/10.1080/03007995.2022.2057153