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. 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

Warren W Acker  1 , Joseph M Plasek  2 , Kimberly G Blumenthal  3 , Kenneth H Lai  4 , Maxim Topaz  5 , Diane L Seger  6 , Foster R Goss  7 , Sarah P Slight  8 , David W Bates  5 , Li Zhou  9
Affiliations

Prevalence of food allergies and intolerances documented in electronic health records

Warren W Acker et al. J Allergy Clin Immunol. 2017 Dec.

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.

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Conflict of interest statement

Disclosure of potential conflict of interest: W. W. Acker, J. M. Plasek, K. H. Lai, M. Topaz, D. L. Seger, S. Slight, and L. Zhou have received a grant from the Agency for Healthcare Research and Quality (grant no. R01HS022728). K. G. Blumenthal has received grants from the Agency for Healthcare Research and Quality (grant no. R01HS022728), the American Academy of Allergy, Asthma, and Immunology, and the National Institutes of Health/National Institute of Allergy and Infectious Diseases.F. R. Goss has received grants from the Agency for Healthcare Research and Quality (grant nos. R01HS022728 and R21) and has stock/stock options in CareLoop. D. W. Bates has received a grant from the Agency for Healthcare Research and Quality (grant no. R01HS022728); is a coinventor on Patent No. 6029138 held by Brigham and Women’s Hospital on the use of decision support software for medical management, licensed to the Medicalis Corporation; holds a minority equity position in Medicalis; serves on the board for SEA Medical System; consults for Early Sense; receives equity and cash compensation from QPID, Inc; receives cash compensation from CDI (Negev), Ltd; and receives equity from Enelgy, ValeraHealth, Intensix, and MDClone.

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