title: Surveillance of contrast-media-induced hypersensitivity reactions using signals from an electronic medical recording system.
abstract: BACKGROUND
  Contrast-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.
  
  
  OBJECTIVE
  To analyze the incidence and clinical characteristics of CM hypersensitivity using an EMR-based surveillance system.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Detection 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.
  
  
  CONCLUSIONS
  A 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.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Min-Hye
authors.initials: MH
authors.lastname: Kim
authors.forename: Chang-Han
authors.initials: CH
authors.lastname: Park
authors.forename: Duk-In
authors.initials: DI
authors.lastname: Kim
authors.forename: Kyung-Mook
authors.initials: KM
authors.lastname: Kim
authors.forename: Hui-Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Kyu-Hyoung
authors.initials: KH
authors.lastname: Lim
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Song
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Sae-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hyouk-Soo
authors.initials: HS
authors.lastname: Kwon
authors.forename: Heung-Woo
authors.initials: HW
authors.lastname: Park
authors.forename: Chang-Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: Kyung-Up
authors.initials: KU
authors.lastname: Min
authors.forename: You-Young
authors.initials: YY
authors.lastname: Kim
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Chang
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D004396:Coloring Agents / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D057286:Electronic Health Records; D006801:Humans; D006967:Hypersensitivity; D011159:Population Surveillance; D012189:Retrospective Studies
chemical_list: D004396:Coloring Agents; D003287:Contrast Media