Alergia

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Prevalence of food allergies and intolerances documented in electronic health records

Warren W. Acker, MS

, 

Joseph M. Plasek, MS

, 

Kimberly G. Blumenthal, MD, MSc

, 

Kenneth H. Lai, MA

, 

Maxim Topaz, RN, MA, PhD

, 

Diane L. Seger, RPh

, 

Foster R. Goss, DO, MMSc

, 

Sarah P. Slight, PhD, MPharm, PGDip

, 

David W. Bates, MD, MSc

, 

Li Zhou, MD, PhDCorrespondence information about the author MD, PhD Li ZhouEmail the author MD, PhD Li Zhou

DOI: http://dx.doi.org/10.1016/j.jaci.2017.04.006

Article Info

• Abstract

• Full Text
• References

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.

Key words:

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

Abbreviations used: 

EHR (Electronic health record), OFC (Oral food challenge), PEAR(Partners' Enterprise-wide Allergy Repository), RAST(Radioallergosorbent test)

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

4000-1054

2208-8206

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