Two LOINC codes for one lab-item

Ian McNicoll ian at freshehr.com
Fri Feb 17 04:58:39 EST 2017


Hi Robert,

Thanks for the input.  This is going to be a universal issue, however and
wherever we are trying to aggregate bits of 'clinically identical' lab data
as-per your example.

I am interested in how this is done now, as LOINC is not extensively used
in the UK outside individual institutions, and my understanding is that the
LOINC terminology carries enough relationship metadata to allow

2160-0 Creatinine [Mass/volume] in Serum or Plasma        Creatinine
Qn         mg/dL
14682-9 Creatinine [Moles/volume] in Serum or Plasma      Creatinine
Qn         umol/L

to be queried/inferenced as 'Creatinine Serum or Plasma' but this would
require a LOINC-aware terminology server.

or do folk just manually document the sets of terms to be queried?

Ian

Dr Ian McNicoll
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Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 16 February 2017 at 13:51, Robert Hausam <rrhausam at gmail.com> wrote:

> In recent months I've had some discussions with Dan Vreeman at Regenstrief
> about the need to be able to group or aggregate "clinically equivalent"
> LOINC codes (however "clinically equivalent" is defined - mol and mass is
> one obvious case).  The original impetus for our discussion isn't being
> pursued on my end at the moment, but Dan did say that Regenstrief is
> embarking on an effort of their own to develop the capability for doing
> something like this.  I am sure that they would be interested in hearing
> about use cases that are being identified that need this capability (and
> also about anyone with an interest in helping them with getting the work
> done).
>
> Rob
>
> On Thu, Feb 16, 2017 at 6:23 AM, Wouter Zanen <w.zanen at eurotransplant.org>
> wrote:
>
>> The use case discussed was our use case. All that has been explained
>> makes perfect sense from a lab perspective (Mol and Mass are different
>> test), however in our use case we do need to aggregate them.
>>
>> In our case it is allowed to report have for example createnine in both
>> mg/dl and mmol/l, in the software application it will be one field with a
>> choice for the unit, we receive info from multiple labs in europe). We are
>> also looking for the possibility for electronic exchange of HL7v2 messages
>> in the future. We use the lab test observation (inlcuding specimem
>> details)  and lab test panel to record the test result. We try to bind with
>> both SNOMED and LOINC (being flexible), on a template level I see only two
>> solutions:
>>
>> I now see two options:
>>
>>    - Either we don't bind to LOINC and MAP Loinc codes in the mapping
>>    software we inevitable are going to need to process the HL7V2 message.
>>    Result is one archetype with both mol and mass units.
>>    - Or we invent a testfinding container archetype (Called Creatinine
>>    that binds to Snomed) and under that we have two test panel archetypes for
>>     Mol and Mass. This makes building the app more difficult but at least we
>>    know the composition is related to Createnine.
>>
>> Currently we prefer solution 1.
>>
>> Best regards,
>>
>> Wouter Zanen
>>
>>
>>
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>> >>> Ian McNicoll <ian at freshehr.com> 16/02/2017 11:04 >>>
>> Helpful but do rely on having some fairly sophisticated terminology
>> services and available mappings.
>>
>> We should keep this dialogue going as we will be working in a mixed loinc
>> snomed environment in a uk project.
>>
>> Ian
>> On Thu, 16 Feb 2017 at 09:38, Bert Verhees <bert.verhees at rosa.nl> wrote:
>>
>>> Very well thought out guidelines in the second part. Will be helpful in
>>> the discussion
>>>
>>> Thanks
>>> Bert
>>>
>>> Op do 16 feb. 2017 om 10:07 schreef Ian McNicoll <ian at freshehr.com>:
>>>
>>> This was helpful but still implies that some sort of terminology service
>>> is required
>>>
>>> https://confluence.ihtsdotools.org/download/attachments/
>>> 12781103/Expo_LOINC_SNOMED_EHR_October_2015_Final.pdf?
>>> version=1&modificationDate=1446571187000&api=v2
>>>
>>>
>>>
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>>> lists.openehr.org
>>
>> --
>> Ian McNicoll
>>
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>
>
>
> --
> Robert Hausam, MD
> +1 (801) 949-1556 <+1%20801-949-1556>
> rrhausam at gmail.com
>
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