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2017 12 06 - LOINC For Beginners
2017 12 06 - LOINC For Beginners
2017 12 06 - LOINC For Beginners
2017
High Level Schedule
1. An overview of LOINC
2. The LOINC Concept Model and
other Data Structures
3. The LOINC Distribution
4. Quick tips for mapping
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329.
The rain forest canopy is a
seamless web through which
arboreal creatures efficiently
move to reach the edible
fruits without any attention
to the individual trees.
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329. photo via nosha | cc-by-sa
Connecting Many Data Sources
Social and community determinants
Health history
Patient-generated
EHR
Genetics
Basic science
photo via Heather | cc-by-sa
The big problem
MO MONEY MO PROBLEMS
data
It's like, the more money
we come across
The more problems we see
MO DATA MO PROBLEMS
Problems
Health IT systems often lack
common mechanisms for MO DATA MO PROBLEMS
exchanging data.
Semantic Standards
Vocabulary/code systems
LOINC, SNOMED CT, RxNorm, ATC, ICD, etc
The global standard for
identifying health
measurements,
observations, and
documents.
Est. 1994
Forrey AW, McDonald CJ, DeMoor G, et al. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic
reporting of clinical laboratory test results. Clin Chem. 1996 Jan;42(1):81-90. PMID: 8565239.
LOINC is
a freely available global standard
75547-0 Noninvasive prenatal fetal aneuploidy 75296-4 Carbohydrate intake 24 hour Estimated
and microdeletion panel based on Plasma cell- 82289-0 Rating of perceived exertion [Score]
free+WBC DNA by Dosage of chromosome-specific
circulating cell free (ccf) DNA 72166-2 Tobacco smoking status NHIS
Units
{
"resourceType": "Observation",
"id": "body-height",
"meta": {
"profile": [
"http://hl7.org/fhir/StructureDefinition/
vitalsigns"
]
},
"text": {
"status": "generated",
"div": ""
},
Same thing.
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
Different format.
"code": "8302-2",
"display": "Body height"
}
],
"text": "Body height"
},
OBX||NM|123^RBC^MyHosp^26453-1^RBC # Bld^LN||4.82|10*6/uL
LOINC Code
LOINC Fully Specified Name
LOINC Code
18262-6
The unique, permanent identifier that
serves as a computer processable
representation of a LOINC Term
Penultimate dash
Final character is Mod-10 check digit
Carries no intrinsic meaning
Once released, never removed
LOINC Names
Julius Winfield Erving II
The Doctor
Dr. J
LOINC Name
The visible display text of a
LOINC Term.
Short Name
Column header, old-school systems with character limits
Example LOINC Names
Fully-Specified Name (FSN)
Urea nitrogen:MCnc:Pt:Ser/Plas:Qn:
Short Name
BUN SerPl-mCnc
LOINC Fully Specified Name
Includes the info necessary to distinguish
among clinically important differences
Property MCnc
Timing Pt
System Ser/Plas
Scale Qn
Property Len
Timing Pt
System ^Patient
Scale Qn
Method
Examples
Component
Sodium
Glucose
Brucella sp. identified
HIV 1 p24 antigen
Cytomegalovirus antibody
Body weight
Example Properties
LOINC Abbreviation Property Example units
MCnc Mass concentration mg/dL
SCnc Substance concentration umol/L
MCnt Mass content mg/g
CCnc Catalytic concentration U/L
Prid Presence or identity
danielvreeman.com/loinc-essentials
Timing
The interval of time over which the
observation or measurement was made
Examples
LOINC Abbreviation Time Aspect
Pt Point in time
12H 12 hour collection
24H 24 hour collection
7D 7 days (look back period)
Examples
LOINC Abbreviation System
Bld Whole blood
Ser/Plas Serum or plasma
Tiss Tissue
Unknown, unspecified in the test name, and/or
XXX
specified in another part of the message.
*See LOINC Users Guide for further discussion
Cholesterol.in LDL:MCnc:Pt:Ser/Plas:Qn:Direct assay
photo via AlishaV | cc-by
Super System
System^Supersystem
Super System
Patient is the default (not specified)
Supersystem identifies a sample from a source other than the patient whose
record the result is being store in
818-5:A Ag:ACnc:Pt:RBC^BPU:Ord:
11670-7:Blood flow.mean:Vel:Pt:Aortic arch^fetus:Qn:US.doppler
Scale
A classification of the result type
Examples
LOINC Abbreviation Scale
Qn Quantitative * can have operators
Ord Ordinal
Nom Nominal
Nar Narrative
Doc Document
70,000
60,000
50,000
40,000
30,000
20,000
laboratory terms only
10,000
0
Lots cooking
Always new lab tests
Public health: emergent issues, surveillance, case reports
Document titles
Patient reported outcomes
Cardiovascular and other clinical measurements
New data models for genetics [HL7]
Structured path reporting for cancer [CAP, ICCR]
Patient reported outcomes [PCORI]
Social determinants of health [many]
MANY active collaborations with other orgs
photo via liber | cc-by
LOINC grows
because USERS ask
Last Year:
New term requests from 50+ organizations in 14 countries
A big toolbox for
Implementers
All available at loinc.org
Class Chem
Status Active
Order/Obs Both
LOINC Accessory Files
Special representations of LOINC content
Accessory Files
LOINC Part File
LOINC Answer File
LOINC Panels and Forms File
LOINC Document Ontology File
LOINC Multiaxial Hierarchy File
LOINC/IEEE Medical Device Code Mapping File
LOINC/RSNA Radiology Playbook File
LOINC/SNOMED CT Expression Association and Map Sets
Takes as input
Local test codes, names, units, and mappings
Returns
Spreadsheet with issues detected by the evaluation process
Sample of Evaluation Rules
Unknown local units
Deprecated LOINC
Discouraged LOINC
Property/units mismatch
Scale/units mismatch
Concentration missing denominator
What LOINC Essentials covers
LOINC basics
danielvreeman.com/tips
Chinese translation available
Happy LOINCing!