Patient and Family Experiences and Support Needs in Pediatric Oral Immunotherapy Decision Making: A Multi-Stakeholder Qualitative Study in Japan
Bibliographic record
Abstract
Oral immunotherapy (OIT) is an emerging treatment for pediatric food allergies; however, decision support strategies in Japan remain underdeveloped and culturally nuanced. This qualitative descriptive study explored the OIT decision-making experiences and support needs of children, their parents, and healthcare professionals. Fourteen participants were recruited from 2 tertiary medical centers in Tokyo and Kanagawa. Individual semi-structured interviews were conducted and thematically analyzed. Three core themes emerged: navigating complex choices by balancing safety, burden, and values; centering on the child's voice through participation, emotional awareness, and autonomy; and bridging gaps in informational, emotional, and peer support to enable shared decision making (SDM). A conceptual model grounded in the Ottawa Decision Support Framework and the Japanese cultural context illustrates how stakeholder-specific needs interact to shape the quality of decisions. This study highlights the rarely examined intersection of pediatric autonomy, clinical uncertainty, and sociocultural context. These findings underscore the need for culturally responsive and child-inclusive SDM strategies and tailored decision aids to support families navigating pediatric OIT.
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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 | 0.010 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.005 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| 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".