Missing Concepts Discovered relating to Allergies

[wlodarmt (Mark Wlodarski)]

Hello, as a part of building our Food Allergy Data Dictionary we have discovered a number of minor missing concepts that our food allergy experts believe to be of importance. Most of these are Observations but here is a list of the ones we have identified:

Foods and Triggers - Observations
Goat Meat - this would ideally be added as a Red Meat under 4037234
Black Beans – there is only a Non standard code for this - 40792667 but there does not seem to be an available standard code for this
Rat Dander - for addition under Animal Dander - 4138133
Date Tree Pollen - for addition under Tree Pollen - 36684363

Other Observations:
Change in Activity Level - there are a number of codes for indicating a specific amount of change in activity, but a generic “change in activity level” is something highly requested by our allergy experts as this is a common observation in children
Prior Antihistimine use - indicates that a person has taken anithistimines without a need to specify the exact drug

Conditions:
Nasal Pruritis - This would be similar to 4038048 - throat irritation
Oral Pruritis - same as above

Reaction Attributes:
We would like the following types of exposure added, these would be similar to “Accidental Exposure” 4115598:
Intentional / self challenge
Assault
Oral Food Challenge Dose
Oral immunotherapy dose - I will be making a separate post about Oral Immunotherapy

Thank you, This post is intended to get the conversation started when it comes to adding these items. I will also be making a few other posts today or this week to detail some other issues we have run into.

[divakhnenko (Daryna Ivakhnenko)]

@Christian_Reich, @Alexdavv look at this topic, please. I saw you have already answered some questions about allergies.

[Alexdavv (Alexander Davydov)]

I saw you have already answered some questions about allergies.

As a part of the work discussed here.

Goat Meat - this would ideally be added as a Red Meat under 4037234
Black Beans – there is only a Non standard code for this - 40792667 but there does not seem to be an available standard code for this

Wait. I thought we’ll be using only pre-coordinated “Allergy to exact food allergen” concepts, as agreed here.
Why do you need values then?

Rat Dander - for addition under Animal Dander - 4138133
Date Tree Pollen - for addition under Tree Pollen - 36684363

This is not a food allergy, right? And you’ll be using post-coordination modeling for environmental allergy?

Change in Activity Level - there are a number of codes for indicating a specific amount of change in activity, but a generic “change in activity level” is something highly requested by our allergy experts as this is a common observation in children

No matter it’s increased or decreased change, right?

Prior Antihistimine use - indicates that a person has taken anithistimines without a need to specify the exact drug

Drug classes administration - not yet resolved in OMOP. The current approach is to capture the drug_exposure records of all the exact antihistamine ingredients taken before. Would that work?
If not, there’s a work-around discussed here.

Nasal Pruritis - This would be similar to 4038048 - throat irritation

No one of concept beneath Nasal mucosa finding and Disorder of the nose are performing?

Oral Pruritis - same as above

Please review all children: Disorder of pharynx and Mouth and/or pharynx finding and Oral mucosa finding and Disorder of oral mucous membrane.

Intentional / self challenge
Assault

Is it about food allergen exposure?
How would separate to entire exposure concepts work? You’ll be using fact_relationships or the same-day criterion?

Oral Food Challenge Dose

Can you please elaborate on this test (what and how is measured)?

[wlodarmt (Mark Wlodarski)]

Wait. I thought we’ll be using only pre-coordinated “Allergy to exact food allergen” concepts, as agreed here.
Why do you need values then?

We also need the actual foods in question, so that we can link them to other diagnosis/observations via the causative agent concept, as well as for therapeutic plans. So we can do things like indicate a food to avoid using “Most important health event to avoid” with “Black Beans” in the value as concept.

This is not a food allergy, right? And you’ll be using post-coordination modeling for environmental allergy?

Correct

No matter it’s increased or decreased change, right?

Yes, we just need a generic “change in activity level” concept

Drug classes administration - not yet resolved in OMOP. The current approach is to capture the drug_exposure records of all the exact antihistamine ingredients taken before. Would that work?
If not, there’s a work-around discussed here.

Yes, in this case we could possibly just make do with the generic “antihistamine” concept

Thank you for providing the concepts for Oral and Nasal Pruritis, those will work

The different exposure types was raised separately here: Additional Exposure Types

Can you please elaborate on this test (what and how is measured)?

This is the dosage for https://athena.ohdsi.org/search-terms/terms/4091751 In this case we would just be interested in tracking that a reaction was caused by a food taken during this test.

Thank you

[Christian_Reich]

We also need the actual foods in question, so that we can link them to other diagnosis/observations via the causative agent concept

Hm. I agree with @Alexdavv. For exampel, where are we going to draw the line between pizza, flammekueche, tarte flambée, pissaladière, garlic fingers, lahmajoun, manakish, pastrmajlija. And that’s before you start looking at the gazillions of toppings. And that is just one dish.

Not sure how we would do such a thing.