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J Allergy Clin Immunol. 2017 Dec;140(6):1587-1591.e1. doi: 10.1016/j.jaci.2017.04.006. Epub 2017 May 31.

Prevalence of food allergies and intolerances documented in electronic health records.

Author information

1
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Geisinger Commonwealth School of Medicine, Scranton, Pa.
2
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah.
3
Harvard Medical School, Boston, Mass; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Edward P. Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston, Mass.
4
Clinical & Quality Analysis, Partners HealthCare System, Boston, Mass.
5
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
6
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Clinical & Quality Analysis, Partners HealthCare System, Boston, Mass.
7
Department of Emergency Medicine, University of Colorado, Aurora, Colo.
8
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom.
9
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Clinical Informatics, Partners eCare, Partners HealthCare System, Boston, Mass. Electronic address: lzhou@bwh.harvard.edu.

Abstract

BACKGROUND:

Food allergy prevalence is reported to be increasing, but epidemiological data using patients' electronic health records (EHRs) remain sparse.

OBJECTIVE:

We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module.

METHODS:

Using allergy data from a large health care organization's EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. We examined the prevalence of reactions that were potentially IgE-mediated and anaphylactic. Data were validated using radioallergosorbent test and ImmunoCAP results, when available, for patients with reported peanut allergy.

RESULTS:

Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 ± 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P < .001) and Asians (4.3% vs 3.6%; P < .001). The most common food allergen groups were shellfish (0.9%), fruit or vegetable (0.7%), dairy (0.5%), and peanut (0.5%). Of the 103,659 identified reactions to foods, 48.1% were potentially IgE-mediated (affecting 50.8% of food allergy or intolerance patients) and 15.9% were anaphylactic. About 20% of patients with reported peanut allergy had a radioallergosorbent test/ImmunoCAP performed, of which 57.3% had an IgE level of grade 3 or higher.

CONCLUSIONS:

Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR's allergy module has the potential to be used for clinical and epidemiological research. The spectrum of severity observed with food allergy highlights the critical need for more allergy evaluations.

KEYWORDS:

Food hypersensitivity; allergy and immunology; anaphylaxis; electronic health records; epidemiology; prevalence

PMID:
28577971
DOI:
10.1016/j.jaci.2017.04.006
[Indexed for MEDLINE]

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