Forum Replies Created
Thanks for the questions. Most of the answers can be found in the LOINC Users’ Guide (the definitive documentation for LOINC). In short, LOINC is a vocabulary standard for clinical and laboratory observations (e.g. tests and measurements), whereas HL7 is a standard for clinical messages. LOINC is designed to work in conjunction with HL7 (i.e. LOINC codes should be used in the OBX-3 “Observation Identifier” field of the OBX segment of an ORU HL7 message.
OIDs identify a set of things much broader than what is encompassed by LOINC. See a brief intro to how OIDs in relation to their use in HL7 here: http://www.hl7.org/oid/index.cfm. For example, there is an OID to identify LOINC as a whole coding system from which concepts are drawn to use within HL7 messages.
We made a few tweaks to the rules for generating these names and have posted an updated report on the main LOINC website:
To prevent potentially malicious behavior, we’ve not allowed posting attachments or embedding files to posts. You could link to a the URL of image file you’ve posted on another website by using the Img tag. For example, here is the LOINC Logo:
The consensus from the LOINC gurus (Clem and Stan) is that LOINC has not made any distinctions between panels and batteries, considering them basically synonymous (see also Section 8 of the LOINC User’s Guide). LOINC has evolved its mechanism for representing and constructing enumerated sets (panels) with other attributes, including classifying the panel elements as:
- Required (R) – The panel element is always expected to be reported when the panel is resulted.
- Optional (O) – The panel element may not be reported with a panel result depending upon institutional policy or capabilities of the reporting lab.
- Conditional (C) – The panel element is a key finding in the panel report and should be assumed to be negative, absent or not present if the panel result does not include data for this element.
At the HL7/LOINC Lab Orders meeting at NLM in December, the attendees discussed adding an additional node of Reflex (R) to this classification list, but were in agreement that the exact details for the reflex conditions couldn’t and shouldn’t be fully specified in the LOINC panel definition. We could would probably add as an attribute a text description of the reflex conditions (in whatever detail we can get) like we do for Conditional elements. This remains an area of future work. We’ve asked for labs to send us details about their most common test batteries (including the list of LOINC codes for the constituent elements) to help inform the creation of a more complete list of panels and to help uncover special issues. To date, we (Regenstrief) have received few replies to this, but would welcome more.
Further clarification on different requirements for Nuclear Radiology and Nuclear Medicine certification:
Good point…it appears to be an oversight on our part. A primary source for the list of Subject Matter Domains was the ABMS listing of physician specialties/subspecialties.
We also filled in non-physician areas with recognized domains as well. The subject matter domain of Nuclear Radiology is a subspecialty of Radiology from the American Board of Radiology. However, ABMS also recognizes the American Board of Nuclear Medicine and its specialty of Nuclear Medicine, which we do not appear to have on our list of Subject Matter Domains.
I’ll follow-up with the LOINC DocOntology folks to see if they have other comments.