[Daniel VreemanModerator]

The publication and use of “pre-release” LOINC codes is discussed in the LOINC Users’ Guide section 11.4. Here is the most relevant portion:

It is understood that providing these codes back to the requestor and listing them on
the LOINC website is done for informational purposes only, with the additional caveat that the concept could
change prior to inclusion in a public release.

The public should not be expected to have adopted such “pre-released” LOINC codes until they appear in a formal
release. Yet, such an approach is valuable because it facilitates the inclusion of new codes in implementation
guides and other documents and systems that have their own, often lengthy, development cycles.

Thus, Labcorps use of the pre-release codes with its clients is a business-to-business decision, but there should not be the general expectation that downstream users should be ready to handle prerelease codes until they are published in an official release.

[Daniel VreemanModerator]

I’ve got a question for our public health colleagues using LOINC. Would it be useful to have groups that pull together tests on isolates from “normally sterile sites”?

If so, is there an agreed list of such specimen sites? (I see, for example, one from MN: http://www.health.state.mn.us/divs/idepc/dtopics/invbacterial/sterile.html)

[Daniel VreemanModerator]

Hi Charles –

As you probably know, LOINC codes are not specific to a particular unit of measure. The Property does constrain which units are allowable for a given LOINC term. For example, and mass/volume unit could be used with a LOINC term that has a Property of MCnc. The units fields in the LOINC table are all meant as “examples”; they are not normative

We are making a few high level groups for LOINC codes that collect terms across Properties. One area of focus initially are groups that collect MCnc and SCnc terms for the same analyte. With the molecular weight, such a group would allow equivalence.

Take a look at the ParentGroup: LG55-6 MassMolConc

It forms Groups that pull together measures of the same analyte with either MCnc or SCnc:

LG10153-1 Bilirubin|Pt|Urine|Test strip|MassMolEquiv|584.662 g/mole
20505-4 Bilirubin.total [Mass/volume] in Urine by Test strip
41016-7 Bilirubin.total [Moles/volume] in Urine by Test strip

• This reply was modified 10 months, 1 week ago by  Daniel Vreeman.
• This reply was modified 10 months, 1 week ago by  Tim Briscoe. Reason: Removed offending HTML tags

[Daniel VreemanModerator]

New “human friendly” view of LOINC Group File posted

Our colleagues at NLM thought it’d be nice to explore the content of the LOINC Group file in an Excel spreadsheet with the subtotal function showing the counts of each group.

We’ve posted this spreadsheet view here:

LOINC 2.61 GroupFile Alpha 1 grouped with counts
requires a free loinc.org login

With this format you can easily expand and collapse the groups in a tree-like structure.

Notes:
This spreadsheet has the columns for parent group and other fields hidden.
Also, don’t try to import this spreadsheet into a database – you’ll get the subtotal rows too. Better to use the main release format: LOINC Group File, Alpha 1

• This reply was modified 11 months, 2 weeks ago by  Daniel Vreeman.

[Daniel VreemanModerator]

Yes, the intention is that from now on every LOINC code in the LOINC Table will be placed in the multi-axial hierarchy – at least at a rudimentary level.

Read more here: LOINC 2.61 release announcement

[Daniel VreemanModerator]

The LOINC PART codes (LP), Answer lists codes (LL), and answer string codes (LA) are not currently distributed as standalone files. You can find key subsets of the Parts in the Multiaxial Hierarchy File, the Document Ontology File, and the LOINC/RSNA Radiology Playbook. Many of the Answer Lists and Answer String codes are available in the Panels and Forms File.

The Regenstrief Institute and the LOINC Committee are in the process of examining both the legal, maintenance, and resource issues involved with distributing other collections of these codes. We hope that in the future we will be able to address these issues and make them available as part of the LOINC release. But, there is no scheduled timeline for that to happen.

[Daniel VreemanModerator]

Hi Jay –

I discussed with RSNA and also consulted with Rob McClure. As far as which code system the RPIDs in this file belong to, it is the code system of RadLex (i.e. the broader RadLex terminology = 2.16.840.1.113883.6.256). Just like the LOINC codes would be drawn from the code system of LOINC.

At present, there is not an identifier (OID) for this mapping file (i.e. the LOINC/RSNA Radiology Playbook) as a whole.

Does that answer your question?

[Daniel VreemanModerator]

We’re going to discuss with the RSNA/RI Radiology Committee. RSNA has an OID for RadLex, but we are discussing whether the Playbook is/should be contained by the same OID as all of Playbook or if it should have its own.

As you know, on the LOINC side, all LOINC concepts (LOINC codes, Part Codes, Answer codes, etc) are covered by the same code system/OID/URI. They may decide to follow that pattern or treat them as separate code systems.

Will report back when we have more info…

[Daniel VreemanModerator]

We forgot to update here, but the FTPS access has been up and running since Wed. So, download away! If you want to learn more about what’s in this latest version of LOINC, read the full announcement here.

[Daniel VreemanModerator]

Hi Maria –

The scope of the current agreement covers lab tests and a subset of clinical measurements (anthropomorphic measurements and evaluations, vital signs and physiological measurements). We chose these domains as a first step, but the organizations anticipate expanding more in the future.

The first drafts of the expression associations and mapping were done only for a subset of lab (we started with the most common tests). You can read more about the content and approach in the documentation of the download. We are working to expand that set to include more content in later work (anticipated later this fall). The SNOMED Observables model is still being tested and evaluated for clinical content, so when and how that content will be represented is still a work in progress.

[Daniel VreemanModerator]

Check out answers to the question “Where can I find previous versions of LOINC to download?” in the FAQ Entry on the main LOINC website.

[Daniel VreemanModerator]

Yes, correct, you’d do multiple projections in the Component by separating them with an “&”, e.g.:

http://search.loinc.org/search.zul?query=ap+lateral+xr

You’re correct that we haven’t totally nailed the convention for multiple modalities, but our current approach (being shaped in our collaboration with the RSNA) is to use a “+” to separate them. For example “PET+CT”. So, that’s how I’d recommend you submit them. You’ve likely noticed that this is different than our convention for “sub” modalities, e.g. MRI.angio.

Also, please provide a short description of each exam (i.e. what the imaging procedure is and what it is used for) you are requesting.

Thanks! We look forward to your request.

[Daniel VreemanModerator]

Take a look at the Radiology tutorial slide deck that is available at:

http://loinc.org/slideshows/clinical-loinc-tutorial/2013-02-14-clinical-loinc-tutorial-imaging.html

Then, take a look at the very detailed discussion of Radiology naming conventions in the LOINC User’s Guide (Chapter 4.3):

http://loinc.org/resolveuid/5b10b078cb8a73852124468027bc9808

Before you make a submission for new terms, you should scour the examples of radiology terms in LOINC already (there are about 5,000 of them) to be sure the one you’re requesting isn’t already there. You’ll find them in the class of RAD:

http://search.loinc.org/search.zul?query=class%3Arad

When you find a gap, then use the naming conventions and patterns above to complete your submission. So, the analyte = the piece of the LOINC Component before the Challenge. The method is the modality.

[Daniel VreemanModerator]

Sorry, Regenstrief doesn’t produce a publicly available web service or API.

[Daniel VreemanModerator]

From LOINC’s perspective, I think it is probably your choice. (Not sure what HL7 SDWG would say). The LOINC code is meant to identify the expected information contents of that item. LOINC’s definition of HPI (which could be improved) is based on the general use of the phrase in medicine…which employs a broad definition of “illness” that would include trauma. In the context of trauma, an HPI might include things like the mechanism of injury, timing of the injury, situational details (entrapment, airbag deployment, etc), other prehospital assessments,etc (per The trauma manual: trauma and acute care surgery). So, I think it would be reasonable to use the HPI template if it fits your needs. The advantage of using an injury-specific code would be that you could find it much more easily amidst all the other HPI’s.

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