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. 2024 Jul 25:11:23333928241264020.
doi: 10.1177/23333928241264020. eCollection 2024 Jan-Dec.

Applying Market Basket Analysis to Determine Complex Coassociations Among Food Allergens in Children With Food Protein-Induced Enterocolitis Syndrome (FPIES)

Ankona Banerjee  1 , Kenneth Nobleza  1 , Cynthia Haddad  2 , Joshua Eubanks  2   3 , Ruchit Rana  2   3 , Nicholas L Rider  4 , Lisa Pompeii  5 , Duc Nguyen  1 , Sara Anvari  2   3   6
Affiliations

Applying Market Basket Analysis to Determine Complex Coassociations Among Food Allergens in Children With Food Protein-Induced Enterocolitis Syndrome (FPIES)

Ankona Banerjee et al. Health Serv Res Manag Epidemiol. .

Abstract

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy, characterized by delayed onset of repetitive vomiting occurring 1 to 4 h following ingestion of a food allergen. Managing FPIES requires strict avoidance of the food trigger. The concern with FPIES is determining the risk of another FPIES food trigger reaction due to potential coassociations with other foods or food groups. An effective statistical approach for analyzing FPIES-related data is essential to identify common coallergens and their associations.

Methods: This study employed Market Basket Analysis, a data-mining technique, to examine correlations and patterns among allergens in FPIES patients at a Houston, Texas, pediatric tertiary center. A retrospective analysis of electronic medical records from January 2018 to March 2022 for allergist diagnosed FPIES patients was conducted. The analysis utilized R software, specifically the "arules" and "arulesViz" packages, implementing the Apriori algorithm with set minimum support and confidence thresholds.

Results: The study included 210 FPIES cases over 4 years, with 112 patients reacting to one food trigger and 98 to more than one trigger. In the latter group, the 5 predominant triggers were cow's milk (45.9%), rice (31.6%), oats (30.6%), soy (22.4%), and avocado (19.4%). Market Basket Analysis identified significant associations between food categories, particularly between soy and dairy, egg and dairy, oat and dairy, rice and dairy, and avocado and dairy.

Conclusion: Market Basket Analysis proved effective in identifying patterns and associations in FPIES data. These insights are crucial for healthcare providers in formulating dietary recommendations for FPIES patients. This approach potentially enhances guidance on food introductions and avoidances, thereby improving management and the quality of life for those affected by FPIES.

Keywords: epidemiology; food allergens; market basket analysis.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SA receives research grant funding from NIH/NIAID and DBV. SA serves on the medical advisory board for the International FPIES Association (iFPIES). NLR receives research grant funding from NIH/NIAID, Takeda Pharmaceuticals and The Jeffrey Modell Foundation. NLR also serves on the following scientific advisory boards: Takeda and Pharming Healthcare. NLR receives royalties from Wolters Kluwer for contributions to UpToDate.

Figures

Figure 1.
Figure 1.
Visualization of allergen occurrence among participants, based on the frequency of each allergen.
Figure 2.
Figure 2.
Distribution of triggers in those reporting FPIES to more than one food. The offset slices are intended to highlight the most common triggers.
Figure 3.
Figure 3.
Lift as one of the important determinants of correactivity between food allergies.
See this image and copyright information in PMC

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