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Background: Most children with egg allergy (EA) can tolerate extensively heated and baked egg (EHBE). Consumption of EHBE may promote faster resolution of EA; however, no consensus exists as to the required amounts and treatment protocols.Objective: To evaluate the efficacy and safety of a structured graduated exposure protocol (SGEP) with EHBE in promoting tolerance to eggs in EA children under 2 years of age. Methods:In a case-control study, EA children aged < 2 years who were treated with SGEP including EHBE were compared to children treated with strict avoidance. Data were collected from records and telephone questionnaires. Analysis was performed using non-parametric Kaplan-Meier and Cox proportional hazard regression models.Results: Thirty-nine egg-allergic children with a median age at intervention of 16 months (interquartile range: 13-19) were treated with SGEP and followed to a median age of 39 months (26.8-50.0). The median age at resolution of EA was compared to a matched group of 80 children treated with strict avoidance at least until 2 years of age or earlier natural resolution and followed to a median age of 69 months (46-104).The median estimated age at EA resolution in the SGEP group was 24 months (95% CI, 19.5-28.5 months), compared to 78 months (95% CI, 53-102) in the control group, P < .001. At last follow-up, 82% of treated children were tolerant to lightly cooked eggs vs 54% of controls, P = .001. Conclusion:A structured protocol with EHBE appears to promote faster resolution of EA. K E Y W O R D Satopic dermatitis, egg allergy, food allergy, heat denatured proteins, structured graduated protocol, wheezing | 825 GOTESDYNER ET al.

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Background Technological development of remote healthcare has accelerated since the outbreak of the COVID-19 virus. While telemedicine offers an efficient way to deliver care, it also presents considerable new challenges. In this study, we examined family physicians’ and pediatricians’ perceptions regarding three aspects of the use of telephone visits: quality of care, safety of care, and physicians’ satisfaction.Methods This mixed-methods study surveyed 342 family physicians and pediatricians in Clalit Health Services (Clalit) regarding their perceptions toward using telephone visits. Participants responded to an online survey that included demographic questions and eighteen 5-point Likert scale statements describing quality, safety, and physicians’ satisfaction with telephone visits. This was followed by in-depth interviews with 26 physicians between January to April 2023.Results Participants expressed high satisfaction (3.66 ± 0.80) with the use of telephone visits and lower assessments of safety (3.03 ± 0.76) and quality (2.27 ± 0.76) of care using the telephone modality. Eighty percent of the respondents think combining a face-to-face visit with a telephone visit is recommended and 51% noted that the inability to examine the patient closely affects and impedes the physician’s decision-making. Most interviewees indicated that telephone visits are safe only with former patients they had already seen in the clinic. Interviewees suggested improvements, such as patient education, a decision support system, and technological upgrades to the modality.Conclusions The findings shed light on the perceptions of family physicians and pediatricians regarding telephone visits. Although satisfaction with telemedicine is generally high, the differing opinions regarding the quality and safety of the telephone meeting underscores the need for careful use of telephone visits in healthcare. The findings uncover the barriers for the acceptance of this modality and our recommendations may help healthcare organizations to improve the use and increase the acceptability of this service, including proper and balanced selection of patients, implementing technological upgrades to the modality and performing patient education practices.