HOME EGG LADDER INITIATION IN CHILDREN WITH ISOLATED CUTANEOUS SYMPTOMS FOLLOWING EGG EXPOSURE
Bibliographic record
Abstract
Introduction Referrals for cutaneous symptoms following egg exposure are commonly received by pediatric allergists. At our community allergy clinic, 47% of food allergy referrals for 0–2-year-olds involve egg. Rather than traditional egg avoidance, the Canadian Egg Ladder facilitates reintroduction. We describe home egg ladder initiation in patients with cutaneous symptoms, to assess safety and potential to decrease allergist assessments. Methods From 2018–2025, 0–2-year-olds with isolated cutaneous symptoms began the egg ladder at home, without in-person allergist assessment. Caregivers were educated on initiation, and epinephrine autoinjectors were prescribed. Patients were reviewed every 3–6 months. Demographics, adverse reactions, and ladder progress were recorded. Descriptive statistics were analyzed in Excel. As quality improvement, this study was exempted from IRB approval. Results Of 116 patients who began the egg ladder, 84% (n=97) completed it. Median initiation age was 12 months (IQR 9–16); average completion time was 6 months (IQR 2–9). Twenty-five patients (22%) experienced adverse reactions, predominantly contact rashes (18/25; 72%). Six experienced grade 1 CoFAR reactions, two experienced grade 2 CoFAR reactions. No patients required epinephrine. Attrition rate was 8%; 7% transitioned to oral immunotherapy (5 ladder failure, 2 parental anxiety, 1 logistical burden). Based on egg tolerance by time of allergy assessment, ladder initiation by referring providers could have prevented 63% of allergy referrals. Conclusion This study supports safe, effective home initiation of the egg ladder for pediatric patients with isolated cutaneous symptoms after egg exposure. Implementing ladders in primary care may reduce unnecessary allergist referrals, shortening wait times and improving access for those requiring specialist care.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".