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Our team has found success in mapping all results of all panels/tests first. All orderables that are single result fields get the same LOINC for the order side. Returning to the panels/groups will allow you to choose the best LOINC term with the Required, Optional, Conditional, Reflex w/alternative of that panel. You’ll notice some panels only have suggested components, but none required. With none required, be sure the display and intent of the local panel fits the display and intent of the LOINC term.
The one strict rule we adhere to are the required fields of a panel. If there is not a good fit amongst the LOINC panels, you are encouraged to provide feedback to Regenstrief under the Content / Request New / Request Edit to Existing section.
Have a great week,
As mentioned yesterday, having default LOINC terms defeat the purpose of interoperability. The use case of identifying laboratory assays would not be met if all assays are tagged with the same term.
I would like to help you make traction in your project, even if it is only in initial stages. Please email me at firstname.lastname@example.org
I have forwarded your message to the LabCorp representative sitting on the lab LOINC committee.
Have you watched the videos at https://loinc.org/learn/ ? There is a learning curve for the mapper, in addition to assuring you’ve got the best possible extract for your local terms to work from.
For the question on how to map Glucose-124, you need to have the information of specimen type (serum, urine, csf, etc) along with the units of measure. I also like to see the orderable test information, to assure we’re not dealing with a challenge test.
For the question of a default LOINC term, having a “one size fits all” term defeats the purpose of creating a computer-understood label or tag to accompany local terms in electronic data exchange. There are instances where a specialist review is used across multiple assays; there are role specific terms such as clinical biochemist review, coagulation specialist review, etc. You can find them by entering ‘ review imp xxx ‘ in RELMA
Would you like to share a portion of your mapping extract for adequacy review? You can email me at email@example.com.
Hope some of this helps you,
It’s imperative to begin mapping with an extract that contains specific data requirement. See RELMA User’s Guide for requirements in creating your local file (LMOF). Mapping from only a display name won’t help you make progress. Ask the end user what is being reported? Does it chart to the clinician? It may be their positive glucose control, for example. If you have access to example reports to clinicians, more information can be gleaned.
All the best,
I also do not find a blood pressure measurement for 89408-* or 8940-8; so let’s discard that. What are example answers of “Ambulatory Blood Pressure Monitor testing”? If you’re in RELMA for Blood Pressure, you’ll see postcoordinated systolic/diastolic, or individual fields for systolic or diastolic…. there’s also orthostatic bp and a panel for either blood pressure or orthostatic blood pressure. I’m curious what “ambulatory” may have to do with it; there are different systems for facility or clinic notation, but usually the system of Patient or Arterial System satisfies a blood pressure case.
In general, it may help to use as few keywords as possible in your initial searches in RELMA to get the hang of it. Let me know how else I can assist in getting you grounded in LOINC work.
All the best, Pam
If you need just a specimen type LOINC, there are several options:
66746-9 – Specimen type
31208-2 – Specimen source
The latter is widely used, in our experience.
Hope this helps!
Thank you for your persistence in getting examples into the LOINC User’s Forum. Your statement notes that “because other types of findings might be part of the Report Document….specifically is the PAP finding”, we would probably not use a Doc scale for the LOINC. The statement infers to me that there may be other portions of the report describing items like clinical history statement of adequacy, follow up recommendation. There are LOINCs for all of these.
For a.1 of your model, I would propose 19762-4 General categories [Interpretation] of Cervical or vaginal smear or scraping by Cyto stain. The answers of Normal, Low-Grade Squamous Intraepithelial Lesion, High-Grade Squamous Intraepithelial Lesion are all interpretations made by the cytology staff. Indeed, those answer values you found in SNOMED CT would be associated with the information system field mapped to 19762-4, identifying what is being reported. In the LOINC User’s Guide, there is a suggestion that LOINC maps to the field holding what is being reported and SNOMED CT identifiers map to the example answers in laboratory, cytology, and pathology reports.
I hope this conversation is of help to you. Have a great day!
There is a special property within the LOINC database for your examination: MSCNC – Mass Substance Concentration. It allows for the combination of lab values of mass/volume or substance/volume units of measure. 35194-0 is for serum or plasma Bilirubin quantitative and 35193-2 is for body fluid Bilirubin.
If you simply enter MSCNC in RELMA search window, you’ll see the covered analytes in different body fluids. If a particular analyte is’t covered, you can submit to Regenstrief for a new term.
Hope this helps. Let me know what else can be answered.
I see Mira responded to one question in your email. For the shortname display issue, keep in mind there was a time period where not all shortnames had been created. After the creation formula was decided, it took several versions to implement. So as you reverse engineer backwards, you’ll see the terms that didn’t have displays at one point in time.
I hope this helps.
If you’ll type in the display name of each field, we’ll go from there.
Please take a look at the outbound messaging format of your cytology reporting; this helps determine if the single document LOINC should be used, or if individual observations reside in separate OBX segments (pointing to individual LOINC observations).
There are individual LOINCs under Microscopic Observation with methods of cyto stain, cyto stain.thin prep, or cytology.non-gyn . Other observations such as Clinical History, General Categories and Statements of Adequacy have LOINCs as well. There is also a Pathology Biopsy Report for cervix specimen.
Please give a detail example of what you are looking for, and I’ll be glad to help. All the best, Pam
Does your assay happen to test for the galactomannan antigen, that is common across several fungi genus. Here’s the RELMA definition : Galactomannan is a polysaccharide cell wall component in certain species of fungi. The assay is used for the early diagnosis of invasive aspergillosis in immunocompromised patients undergoing hematopoietic stem cell transplantation and in patients with hematological malignancy. Other fungal sources galactomannan include Alternaria, Penicillium and Paecilomyces species, but these fungi are rarely seen in invasive disease.
This is the analyte I use in client mappings; there are several serum specimens available.
I was deferring to the HL7 CDA RMIM to define if there should be alphabetic strings or numeric code, pertaining to LOINC class. This was based on a premise that the reporting is taking place on assays with LOINC terms attached. It’s a “drill down” from the involved LOINC terms for each patient to have a table pull of the associated CLASS field in the LOINC database.
As for the second question, each LOINC term only has one class assigned it in the database. In our experience the LOINC-assigned class serves as a baseline of organization, but it does not mimic the real world laboratory workstations/departments (which I am aligning with the “lab specialty” term being used). For example, the PULM class blood gas measurements are often performed in a medical laboratory setting, rather than the pulmonary department. However, a medical laboratory will provide a variety of assays (described in their electronic Directory of Services [eDOS]) and these cross many LOINC classes.
Perhaps I am not understanding the context of the word ‘CLASS’ in the original question.
Not being familiar with Italian laws, but realizing HL7 CDA has the RMIM to identify source material; wouldn’t the HL7 CDA RMIM prescribe the format definition for the related lab specialty class? It seems the alpha character format of the CLASS field within the LOINC database (DRUGDOSE, DRUG/TOX, MOLPATH.MUT, etc) that is easily retrievable by the computer.
Thanks for helping educate me,