{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T19:32:40Z","timestamp":1771356760254,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS022728"],"award-info":[{"award-number":["R01HS022728"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To develop a comprehensive value set for documenting and encoding adverse reactions in the allergy module of an electronic health record.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We analyzed 2\u2009471\u2009004 adverse reactions stored in Partners Healthcare\u2019s Enterprise-wide Allergy Repository (PEAR) of 2.7 million patients. Using the Medical Text Extraction, Reasoning, and Mapping System, we processed both structured and free-text reaction entries and mapped them to Systematized Nomenclature of Medicine \u2013 Clinical Terms. We calculated the frequencies of reaction concepts, including rare, severe, and hypersensitivity reactions. We compared PEAR concepts to a Federal Health Information Modeling and Standards value set and University of Nebraska Medical Center data, and then created an integrated value set.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 787 reaction concepts in PEAR. Frequently reported reactions included: rash (14.0%), hives (8.2%), gastrointestinal irritation (5.5%), itching (3.2%), and anaphylaxis (2.5%). We identified an additional 320 concepts from Federal Health Information Modeling and Standards and the University of Nebraska Medical Center to resolve gaps due to missing and partial matches when comparing these external resources to PEAR. This yielded 1106 concepts in our final integrated value set. The presence of rare, severe, and hypersensitivity reactions was limited in both external datasets. Hypersensitivity reactions represented roughly 20% of the reactions within our data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We developed a value set for encoding adverse reactions using a large dataset from one health system, enriched by reactions from 2 large external resources. This integrated value set includes clinically important severe and hypersensitivity reactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This work contributes a value set, harmonized with existing data, to improve the consistency and accuracy of reaction documentation in electronic health records, providing the necessary building blocks for more intelligent clinical decision support for allergies and adverse reactions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocx139","type":"journal-article","created":{"date-parts":[[2017,11,4]],"date-time":"2017-11-04T20:09:19Z","timestamp":1509826159000},"page":"661-669","source":"Crossref","is-referenced-by-count":38,"title":["A value set for documenting adverse reactions in electronic health records"],"prefix":"10.1093","volume":"25","author":[{"given":"Foster R","family":"Goss","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Colorado, Aurora, CO, USA"}]},{"given":"Kenneth H","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA"}]},{"given":"Maxim","family":"Topaz","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Durham, UK"}]},{"given":"Warren W","family":"Acker","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"}]},{"given":"Leigh","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"}]},{"given":"Joseph M","family":"Plasek","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA"},{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"}]},{"given":"Kimberly G","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, and Medical Practice Evaluation Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}]},{"given":"Diane L","family":"Seger","sequence":"additional","affiliation":[{"name":"Clinical and Quality Analysis, Partners HealthCare System, Boston, MA, USA"}]},{"given":"Sarah P","family":"Slight","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Durham, UK"},{"name":"Newcastle upon Tyne Hospitals NHS Foundation Trust, UK"}]},{"given":"Kin","family":"Wah Fung","sequence":"additional","affiliation":[{"name":"National Library of Medicine, Bethesda, MD, USA"}]},{"given":"Frank Y","family":"Chang","sequence":"additional","affiliation":[{"name":"Clinical and Quality Analysis, Partners HealthCare System, Boston, MA, USA"}]},{"given":"David W","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, USA"},{"name":"Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Durham, UK"},{"name":"Harvard Medical School, Boston, MA, USA"}]},{"given":"Li","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of General Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, 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