• Min-Hye Kim, Chang-Han Park, Duk-In Kim, Kyung-Mook Kim, Hui-Kyu Kim, Kyu-Hyoung Lim, Woo-Jung Song, Sang-Min Lee, Sae-Hoon Kim, Hyouk-Soo Kwon, Heung-Woo Park, Chang-Jin Yoon, Sang-Heon Cho, Kyung-Up Min, You-Young Kim, and Yoon-Seok Chang.
• Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
• Ann. Allergy Asthma Immunol. 2012 Mar 1;108(3):167-71.

BackgroundContrast-media (CM) hypersensitivity is a well-known adverse drug reaction. Surveillance of adverse drug reactions usually depends on spontaneous reports. However, the rate of spontaneous reports is low. Recent progress in information technology enables the electronic search on signals of adverse drug reactions from electronic medical recording (EMR) systems.ObjectivesTo analyze the incidence and clinical characteristics of CM hypersensitivity using an EMR-based surveillance system.MethodsThe surveillance system used signals from standardized terms within the international classification of nursing practice terms that can indicate symptoms of CM hypersensitivity and from the order codes for procedures that used contrast media, antihistamine, and epinephrine. The search strategy was validated by allergists comparing the electronic search strategy versus manually reviewing medical charts over one month. The main study covered for one year period.ResultsDetection rate of the electronic search method was 0.9% (7/759), while that of the manual search method was 0.8% (6/759). EMR-based electronic search method was highly efficient: reduced the charts that needed to be reviewed by 96% (28/759). The sensitivity of electronic screening was 66.7%, specificity was 99.6%, and the negative predictive value was 99.7%. CM hypersensitivity reactions were noted in 266 among 12,483 cases (2.1%). Urticaria was the most frequent symptom (74.4%). CT was the most frequent procedure (3.6%) that induced CM hypersensitivity.ConclusionA surveillance system using EMR may be a useful tool in the study of drug hypersensitivity epidemiology and may be used in an adverse drug reaction alarm system and as a clinical, decision making support system.Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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