The Brief Environmental Exposure and Sensitivity Inventory (BREESI): an international validation study

Abstract Background Chemical intolerance (CI) is a condition that may result in multisystem symptoms triggered by low levels of exposure to xenobiotics such as chemical inhalants, foods, and/or drugs. The population prevalence self-reported estimated be between 4 and 25% across several countries. Clinicians researchers require brief, practical screening tool for identifying intolerance. Objectives We investigated the validity three-item questionnaire CI, Brief Environmental Exposure Sensitivity Inventory (BREESI). internationally validated, widely used 50-item Quick (QEESI) was reference standard. Methods Five thousand individuals ( n = 1000 each five countries: US, Japan, Italy, Mexico, India) responded both QEESI BREESI using an online research survey platform. determined statistical performance metrics BREESI, comparing number items chosen on with scores Logistic regression determine likelihood based endorsing 0, 1, 2, or 3 BREESI. report BREESI's sensitivity specificity, positive negative predictive values, ratios. Results Compared standard, had excellent sensitivity, ratios, values all countries except than value poor. Notwithstanding, logistic curves show countries, one-unit increase items, there 4- 5-fold odds CI. Discussion This study confirms results two recently published validation papers US. performs well It researchers, clinicians, epidemiologists seeking understand address this important prevalent condition.