Two LOINC codes for one lab-item

Daniel Karlsson daniel.karlsson at liu.se
Fri Feb 17 06:56:15 EST 2017


Dear All,

this is what the LOINC-SNOMED CT mapping intends to achieve. Below are the two SNOMED CT representations of the two LOINC codes:

2160-0 Creatinine [Mass/volume] in Serum or Plasma
'Observable entity (observable entity)'
 and (Component some 'Creatinine (substance)')
 and (Scale some 'Quantitative (qualifier value)')
 and ('Time aspect' some 'Single point in time (qualifier value)')
 and ('Property Type' some 'Mass concentration (property) (qualifier value)')
 and ('Inheres In' some 'Plasma (substance)')
 and ('Direct Site' some 'Acellular blood (serum or plasma) specimen (specimen)')

14682-9 Creatinine [Moles/volume] in Serum or Plasma
'Observable entity (observable entity)'
 and (Component some 'Creatinine (substance)')
 and (Scale some 'Quantitative (qualifier value)')
 and ('Time aspect' some 'Single point in time (qualifier value)')
 and ('Property Type' some 'Substance concentration (property) (qualifier value)')
 and ('Inheres In' some 'Plasma (substance)')
 and ('Direct Site' some 'Acellular blood (serum or plasma) specimen (specimen)')

This expressions (which could be queried for or added as a grouper SNOMED CT concept):

'Observable entity (observable entity)'
 and (Component some 'Creatinine (substance)')
 and (Scale some 'Quantitative (qualifier value)')
 and ('Time aspect' some 'Single point in time (qualifier value)')
 and ('Property Type' some 'Quantity concentration (property) (qualifier value)')
 and ('Inheres In' some 'Plasma (substance)')
 and ('Direct Site' some 'Acellular blood (serum or plasma) specimen (specimen)')

would subsume both.

Regards,
Daniel

On 2017-02-17 11:13, Grahame Grieve wrote:
bit of both - there are some institutions running on a terminology server that can manage those kind of things, and others have to do manual conversion. But terminology servers are gradually becoming more commonly deployed (all the good ones I know of are free).

Grahame


On Fri, Feb 17, 2017 at 8:58 PM, Ian McNicoll <ian at freshehr.com<mailto:ian at freshehr.com>> wrote:
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

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[https://docs.google.com/uc?export=download&id=0BzLo3mNUvbAjUmNWaFZYZlZ5djg&revid=0BzLo3mNUvbAjRzZKc0JpUXl2SkRtMDJ0bkdUcUQxM2dqSVdrPQ]
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On 16 February 2017 at 13:51, Robert Hausam <rrhausam at gmail.com<mailto: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<mailto: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<mailto: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<mailto: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<mailto: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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