Background Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, and age of tolerance depending on the country of origin. We aimed at describing the characteristics of a French population of children with FPIES, and define risk factors for failure during challenge. Methods Data from 179 children who were referred for FPIES in two pediatric tertiary centers between 2014 and 2020 were retrospectively collected. The diagnosis of FPIES was based on international consensus guidelines. Clinical characteristics, culprit food, and age at resolution were assessed. Tolerance was defined as no adverse reaction after OFC or accidental exposure. Results In the 192 described FPIES, the age at first symptoms was 5.8 months old. The main offending foods were cow's milk (60.3%), hen's egg (16.2%), and fish (11.7%). Single FPIES was observed in 94.4% and multiple FPIES in 5.6% of cases. The age at resolution of FPIES was 2.2 years old, and resolution occurred later for fish than for milk (2.9 years vs. 2.0, p = 0.01). Severe acute FPIES was a risk factor for delayed resolution (RR: 3.3 [1.2–9.2]), but not IgE sensitization. Performing a food challenge within 12 months after the first reaction increased the risk of failure (OR: 2.6 [1.1–6.6]). Conclusion In this French cohort of children with FPIES, the main culprit foods were ubiquitous. Rice, oat, and soy were rarely or not involved. Multiple FPIES was infrequent. Our data confirmed the overall good prognosis of FPIES, the later resolution of FPIES to fish and in the case of severe acute FPIES.

Background The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied. Objective The objective of this study was to assess whether an SG better reflects the clinical competence of medical students than a multiple choice questionnaire (MCQ). Methods Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities: high-fidelity simulation (HFS), considered the gold standard for the evaluation of clinical competence, the SG Effic’Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities and the MCQ and HFS modalities. Student satisfaction was also evaluated. Results Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (P=.04). Students reported significantly higher satisfaction with the SG (P<.01) than with the MCQ modality. Conclusions The SG Effic’Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Because SGs allow the assessment of more dimensions of clinical competence than MCQs, they are particularly appropriate for the assessment of medical students on situations involving symptom recognition, prioritization of decisions, and technical skills. Trial Registration ClinicalTrials.gov NCT03884114; https://clinicaltrials.gov/ct2/show/NCT03884114

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Background Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, onset symptoms, and age of tolerance depending on the country of origin. We aimed to describe the characteristics of a French population of children with FPIES. Methods Data from 179 children who were referred for acute or chronic FPIES in two pediatric tertiary centers between 2014 and 2020 were retrospectively collected. The diagnosis of FPIES was based on international consensus guidelines. Clinical characteristics, culprit food and age at resolution were assessed. Results In the 192 described FPIES, the age at first symptoms was 5.8 months old. The main offending foods were cow’s milk (60.3%), hen’s egg (16.2%), and fish (11.7%). Single FPIES was observed in 94.4% and multiple FPIES in 5.6% of cases. The age at resolution of FPIES was 2.2 years old, and resolution occurred later for fish than for milk (2.9 years versus 2.0, p=0.01). Severe acute FPIES was a risk factor for delayed resolution (relative risk: 3.3 [1.2-9.2]), but not IgE sensitization. Performing an oral food challenge within 12 months after the first reaction increased the risk of failure (RR: 2.0 [1.2-3.5]). Conclusion In this French cohort of children with FPIES, the main culprit foods were ubiquitous. Rice, oat and soy were rarely or not involved. Multiple FPIES was infrequent. Our data confirmed the overall good prognosis of FPIES, the later resolution of FPIES to fish and in the case of severe acute FPIES.

BACKGROUND The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied. OBJECTIVE The objective of this study was to assess whether a SG better reflects the clinical competence of medical students than a multiple-choice questionnaire (MCQ). METHODS Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities: high-fidelity simulation (HFS), considered as the gold-standard for the evaluation of clinical competence, the SG Effic’Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities on the one hand, and between the MCQ and HFS on the other hand. Student’s satisfaction was also evaluated. RESULTS Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (p=0.04). Students reported significantly higher satisfaction with the SG (p<0.01) than with the MCQ modality. CONCLUSIONS The SG Effic’Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Our results suggest that SGs can be considered as an additional modality to assess the clinical competence of medical students. CLINICALTRIAL ClinicalTrials.gov (Identifier NCT03884114).