New-onset IgE mediated reactions in eosinophilic esophagitis associated elimination diets (NIMREEDs)
Bibliographic record
Abstract
BACKGROUND: Empiric elimination diets remain a cornerstone of treatment for eosinophilic esophagitis (EoE). Immunoglobulin E (IgE) mediated allergic reactions have been sparsely reported during the food reintroduction phase, raising concerns both for patients and physicians. We aimed to assess the physician reported rates of new-onset IgE mediated reactions in EoE associated elimination diets (NIMREEDs), physician awareness of NIMREEDs, and how awareness impacts physician and patient treatment selection. METHODS: An international REDCap based questionnaire was distributed via interest groups, gastroenterologist server lists, and professional societies. Physicians were asked about their personal awareness and experience with NIMREEDs and how their knowledge affects physician and patient treatment decisions when contemplating elimination diets (ED) for treatment of EoE. RESULTS: Between January and July 2023, 145 responses were included in this analysis. Of the 12,698 patients with EoE cared for in all responding centers, 4903 (38.6%) had attempted ED. NIMREEDs were reported in 43/4903 (0.88% [95% CI 0.5-1.2%]). Ninety-six (66.2%) physicians were aware of potential reactions, however only 71/96 (73.9%) discussed them with patients. Knowledge of NIMREEDs deter 17/96 (17.7%) physicians from recommending ED for EoE, and 15/71 (21.1%) of those who informed patients, reported reluctance of patients to undertake ED. CONCLUSION: NIMREEDs following food re-introduction in the treatment of EoE are uncommon, nevertheless they are not widely recognized by physicians. Knowledge concerning NIMREEDs may affect both patient and physician treatment decisions and preferences, as they have potential to negatively affect quality of life, emphasizing the need for increased awareness to NIMREEDs in EoE patients.
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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 | 0.001 | 0.004 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".