Shared Decision-Making in Food Protein-Induced Enterocolitis Syndrome

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Clinical Management

Background:

• Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by vomiting, lethargy, and potential dehydration.
• FPIES diagnosis is challenging due to nonspecific symptoms and lack of specific diagnostic tests.
• Current FPIES management relies on limited evidence, including case reports and expert opinion.

Purpose of the Study:

• To highlight knowledge gaps and unmet needs in FPIES research and patient care.
• To advocate for an evolved, preference-sensitive approach to FPIES management.
• To emphasize the importance of shared decision-making in optimizing care for FPIES patients and families.

Main Methods:

• Review of current clinical management strategies for FPIES.
• Analysis of the evidence base supporting FPIES treatment.
• Discussion of the role of patient values and preferences in care decisions.

Main Results:

• Limited high-quality trials exist for FPIES, leading to preference-sensitive care decisions.
• The burden of FPIES on patients and families is substantial.
• Opportunities exist to tailor FPIES care to individual patient and family values.

Conclusions:

• FPIES care requires evolution towards a more contextualized, preference-sensitive approach.
• Shared decision-making is crucial for optimal FPIES management.
• Addressing the unmet needs in FPIES research and care is essential.