The Journal of allergy and clinical immunology · 2025
The drug allergy history tool (DAHT): Validation of a patient-reported survey instrument.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Blumenthal Kimberly G, Gundersen Daniel A, Smith Liam R, Nava-Coulter Brett, King Andrew, Phillips Elizabeth J, Gonzalez-Estrada Alexei, Otani Iris M, Ramsey Allison, Banerji Aleena, Chow Timothy G, Stone Cosby A, Salinas Whitney A, Khan David A
Аннотация
BACKGROUND: While the reaction history is critical for drug allergy evaluations and is typically self-reported, there is no validated survey instrument to collect drug allergy history from patients.
OBJECTIVE: We validated a survey instrument that collects patient-reported drug allergy history.
METHODS: The drug allergy history tool (DAHT) was revised after 3 rounds of cognitive testing, assessed for reliability through test-retest comparisons, and assessed for quality and validity through a concordance analysis against electronic health record allergist documentation. Participants completing testing and surveys had 1 or more drug allergies and were recruited from allergy clinics at Massachusetts General Hospital. Primary evaluative measures were percentage agreement and kappa statistic values.
RESULTS: The DAHT was completed by 79 individuals (mean age, 49 [SD 17] years, 85% female, 85% White, 11% Hispanic ethnicity), 29 with single drug allergy labels and 50 with multiple drug allergy labels. The most common drug allergy labels were penicillins (77%), sulfonamides (32%), cephalosporins (15%), and nonsteroidal anti-inflammatory drugs (8%). The DAHT achieved acceptable test-retest reliability (median κ = 0.64, median agreement = 86%). The DAHT achieved a more complete allergy history than allergist documentation in the electronic health record, with lower median item uncertainty (21% DAHT vs 79% electronic health record) with fair concordance (median κ = 0.21, median agreement = 67%) between the two data sources.
CONCLUSION: The DAHT is a reliable and valid source of patient-reported drug allergy information. This tool can be used in clinical care and clinical research to obtain standardized patient-reported drug allergy history.
OBJECTIVE: We validated a survey instrument that collects patient-reported drug allergy history.
METHODS: The drug allergy history tool (DAHT) was revised after 3 rounds of cognitive testing, assessed for reliability through test-retest comparisons, and assessed for quality and validity through a concordance analysis against electronic health record allergist documentation. Participants completing testing and surveys had 1 or more drug allergies and were recruited from allergy clinics at Massachusetts General Hospital. Primary evaluative measures were percentage agreement and kappa statistic values.
RESULTS: The DAHT was completed by 79 individuals (mean age, 49 [SD 17] years, 85% female, 85% White, 11% Hispanic ethnicity), 29 with single drug allergy labels and 50 with multiple drug allergy labels. The most common drug allergy labels were penicillins (77%), sulfonamides (32%), cephalosporins (15%), and nonsteroidal anti-inflammatory drugs (8%). The DAHT achieved acceptable test-retest reliability (median κ = 0.64, median agreement = 86%). The DAHT achieved a more complete allergy history than allergist documentation in the electronic health record, with lower median item uncertainty (21% DAHT vs 79% electronic health record) with fair concordance (median κ = 0.21, median agreement = 67%) between the two data sources.
CONCLUSION: The DAHT is a reliable and valid source of patient-reported drug allergy information. This tool can be used in clinical care and clinical research to obtain standardized patient-reported drug allergy history.