LOINC Release Notes

This section last updated: 2024-08-06 (4 months ago)

Version 2.78, August 2024

Table of contents:

• LOINC table core
• LOINC table
• Answer lists
• Change snapshot
• Consumer names
• Document ontology
• Document ontology OWL
• Groups
• Imaging document codes
• Linguistic variants
• LOINC/IEEE medical device code mapping table
• LOINC/RSNA radiology playbook
• LOINC Universal lab orders value set
• Component Hierarchy By System
• Panels and forms
• Parts
• Updates
• RELMA Changes

LOINC table core

There were no structural changes to the core table in this release, and no future changes to announce at this time. See the Readme included in the LOINC Table Core download file for information about its current file structure.

See the LOINC table notes below for information on content updates included in this release.

LOINC table

Numbers

New terms and totals by type

Totals by Status

Term Status changes

Edits by change type

Content highlights

• Approximately around 250 concepts are created to standardize information models in all areas of healthcare; clinical, financial, supply chain, etc. The information models represent both the structural elements of entities such as patient, provider, and encounter as well as very granular models for instance data such as Blood Pressures, Heart Rates, nursing observations (wound and pain assessments for example), and laboratory observations (potassium, chloride, eGFR, etc.). LOINC codes are assigned to each element and sub-element. These codes are especially useful when health data needs to be translated to specific exchange syntaxes like FHIR, HL7 V2.X, C-CDA, or X12, or for mapping data to analytic schemas like OMOP.
• LOINC codes were requested for a major program to standardize pathology information, terminology and units for safety and quality by advancing laboratory information system interoperability between pathology providers and consumers (General Practitioners and patients) and standardization, adoption, and compliance testing. This project is taking place in Australasia with the support of the Department of Health (DoH).
• As the project between Regenstrief and SNOMED is very active and going forward, the work on LOINC database resulted in:
  • Revisions to a subset of Identified concepts, the rest will be revised in subsequent releases.
  • Revisions to Microscopic Observation concepts
  • Improvement of Parts definitions
  • Cleaning up and reducing duplicates
  • Revisiting Top level Laboratory Observables
  • Configuring new approach and representation of observables related to panel representation, calculation, property like component, and more.

Additional tests created in Laboratory LOINC include:

• New LOINC codes were created supporting FDA approval on Devices for Haemonetics Corp TEG 6s viscoelastic testing capabilities to serve heparinized patients in adult cardiovascular surgeries and liver transplantation in both laboratory and point-of-care settings, additional concepts were created for another FDA approval of a diagnostic system used to identify cervical cancer. The system leverages AI and an algorithm. LOINC supported a new method created for this device.
• LOINC codes were created in support of LIVD catalog: 2 new codes were created to support the representation of line BLOT assays for Borrelia B31 IgG, and IgM. Other was created for MonkeyPox reporting with an emergency use tag.
• In support of Public Health, we created LOINC codes to support a national Laboratory Information Management System (MedLIS) to be introduced to the public health service (HSE), and to support the National Institute for Public Health in the Netherlands.
• We are maintaining and modeling data elements for post-acute care (PAC) assessments in support of Centers for Medicare and Medicaid services.
• In Genetic testing – several genetic codes were created supporting genetic testing by a device, a kit and for a reference lab:
  • Roche Diagnostics International – Cobas for QN detection, mRHBV ND
  • Robert Koch – surveillance data
  • Mixed Chimerism post SCT transplantation quantification of the Donor % of Post Stem Cell Transplantation in patients with hematological diseases
  • HBA1 And HBA2 gene deletion
  • MSCSF (Metagenomic Sequencing, CSF)
  • HPC Product Analysis
• In collaboration with the Diabetes Technology Society, new concepts were created to standardize data associated with continuous glucose monitoring devices.
• We added new concepts for reporting presumptive and definitive results of prescription and non-prescription substances testing.
• In Drug/Toxicology, Therapeutic Drug Monitoring (TDM), Tyrosine Kinase Inhibitors (TKIs) are new candidates for TDM to increase survival time with solid tumors concentration based LOINCs for Imatinib, Pazopanib, Gefitinib, Erlotinib, Sunitinib, Desethyl-sunitinib and Total Sunitinib (all in plasma µg/L units).

Clinical content highlights

• A new LOINC code is created in Document Ontology that is required by International Patient Summary (IPS). IPS will be adding a new section (Alert) to the Composition profile in IPS 2.0 ballot to align with ISO 27269. This new section will highlight extreme problem(s). Alerts are primarily intended to make the attending clinician aware of very important information about health condition(s) affecting the patient.
• New LOINC concepts are released in support of standard data collection protocols for conducting biomedical research. The content is used in The PhenX Toolkit (consensus measures for Phenotypes and exposures).
• Additional new LOINC codes are created to be used by The National Committee for Quality Assurance (NCQA). The High Impact Chronic Pain (HICP) helps in assessing the severity and impact of chronic pain in individuals, allowing for appropriate management and intervention.
• New LOINC codes are used in capturing data to be recorded in the fetal autopsy report, as well as to record health-related documents that have a social and economic impact on the population.
• Concepts to capture measurements derived from Ultrasound Echocardiograms, procedures in Cardiology ultrasound specifically measurements of the ejection fraction, as well as the upper and lower limit of the ejection fraction of the Left heart ventricle.
• New concepts supporting assessment tools around trust in science and scientists
• More concepts developed to investigate psychological and social aspects as part of a COVID-19 study
• Concept corrections and new code requests related to HL7 Advanced Directives Information

Changes to the LOINC Table structure in this release

No changes were made as part of version 2.78.

See Appendix A in the LOINC Users' Guide for the current LOINC table structure.

Answer Lists

See the ReadMe included in the Answer File folder for information about its current file structure.

This release contains all of the answer lists associated with any LOINC term published in the current release. There have been no changes other than the addition of new content since the last release.

Change Snapshot

See the ReadMe included in the Change Snapshot folder for information about its current file structure.

The LoincChangeSnapshot file contains all terms that had a change in Status between LOINC version 2.77 and version 2.78, such as from TRIAL to ACTIVE. It does not contain terms that were newly added in 2.78. In the future, this file will likely contain other types of term changes in addition to Status changes.

The PartChangeSnapshot file contains all of the Parts that had a change in Status between LOINC version 2.77 and version 2.78, such as from ACTIVE to DEPRECATED or ACTIVE to INACTIVE (see ReadMe for Status definitions). In the future, this file may contain other types of Part changes in addition to Status changes.

Consumer Names - Alpha

See the ReadMe included in the Consumer Name folder for information about its current file structure.

This release of the Consumer names file remains at Alpha pre-production status. It contains Consumer names for all Type 1 (Laboratory) and a subset of Type 2 (Clinical) terms in LOINC. The Consumer Names are created algorithmically based on the set of primary rules documented in the associated ReadMe notes.

Consumer Names are intended for downstream display only and are not intended to be used at any point in the clinical workflow, or for the purpose of mapping local terms to LOINC. Their use case includes consumer-facing health and wellness applications that use LOINC to encode the underlying data.

We welcome user feedback about these names.

Document Ontology

See the ReadMe included in the Document Ontology folder for information about its current file structure.

Document Ontology OWL - Alpha

See the ReadMe included in the Document Ontology OWL folder for information about its current file structure.

The Document Ontology OWL file, first released with LOINC version 2.74, includes all the changes and additions to LOINC documents and document ontology values in a format that allows navigation of document axis hierarchies and exchange as a formal ontology. It continues at Alpha status, meaning that it is part of a testing process, and the LOINC team continues to welcome comments regarding its usability and content.

Groups - Beta

See the ReadMe included in the Group File folder for information about its current file structure.

This release of the Group File remains at Beta pre-production status. We received no significant public comments about its contents, structure, or utility that we would have used as the basis for incrementing its maturity level or conceptualization. If you are using this file and have feedback (good or bad), please contact us.

Imaging Document Codes

See the ReadMe included in the Imaging Document folder for information about its current file structure and query used to generate the set of LOINC codes.‌

There have been no changes other than the addition of new content since the last release.

Linguistic Variants

See the ReadMe included in the Linguistic Variants folder for information about its current file structure.

Updated linguistic variants are generally based on the previous release version (i.e., LOINC version 2.77 is translated for inclusion in the 2.78 release). The de_DE German (GERMANY) linguistic variant for 2.78 does contain translations for new terms introduced in version 2.78.

Updated content for the LOINC 2.78 release has been provided by the translation for the following linguistic variants:

The table below shows the LOINC version when each linguistic variant included in this release was last updated.

Please note that some term translations are based on the translation of Parts. For such translations, even if no additional Part translations were provided by the producer, the number of translated terms may vary from release to release because new LOINC terms using previously translated Parts will also be included, and old LOINC terms that have been updated to use untranslated Parts will be excluded.

LOINC IEEE Medical Device Code Mapping Table

See the ReadMe included in the LOINC IEEE Medical Device Code Mapping Table folder for information about its current file structure.

There have been no changes to the structure or contents of this file since the LOINC 2.67 release in December 2019.

LOINC RSNA Radiology Playbook

See the ReadMe included in the LOINC RSNA Radiology Playbook folder for information about its current file structure.

There have been no changes other than the addition of new content since the last release.

The mappings to and content from the RSNA Playbook are based on version 2.4 of that terminology and Radiology Part mappings are based on RadLex version 4.1 and pre-release 4.2.

We are still seeking feedback on the usefulness of the PartSequenceOrder field from anybody who is utilizing this file to help inform our future efforts, e.g., whether we should remove this field.

Known issues:

Parsing issue for terms with multiple Aggregation or View type values in which one or more values is not being assigned the correct PartSequenceOrder value. We plan to address the parsing procedure in a future release if necessary, depending on whether users find this field useful (see request for feedback above).

A few outstanding cases for LOINC Radiology Parts without mappings to RadLex RIDs exists. We plan to review these with RSNA and add mappings, as appropriate, in a future release.

Terms with XXX (meaning Unspecified) as the Region Imaged without an Imaging focus do not have an Anatomy attribute (Region imaged or Imaging focus) represented in the file. The LOINC/RSNA Committee is reviewing the representation of XXX without a specified imaging focus in the LOINC/RSNA model to determine how the Anatomy should be represented.

LOINC Universal Lab Orders Value Set

See the ReadMe included in the LOINC Universal Lab Orders Value Set folder for information about its current file structure.

There have been no changes to this file since the last release.

Component Hierarchy By System

The Component Hierarchy By System (formerly known as Multiaxial Hierarchy) file provides a way to organize LOINC codes based on multiple axes of each concept. See the ReadMe included in the Component Hierarchy By System folder for information about its current file structure.

There have been no changes other than the addition of new content since the last release.

Panels and Forms

See the ReadMe included in the Panels and Forms folder for information about its current file structure.

Parts

See the ReadMe included in the Part File folder for information about its current file structure.

This file contains all of the parts associated with any LOINC term published in the current release. Note that it does not contain Parts that are used to organize terms in the Component Hierarchy By System.

There have been no changes to this file other than the addition of new content since the last release.

Updates

See the ReadMe included in the Updates folder for information about its current file structure. As a reminder, the CHANGE_REASON_PUBLIC and STATUS_TEXT fields are no longer to be considered when determining if a LOINC term has been updated because they contain information for users about term edits but are not directly related to the attributes of a term.

There have been no changes to this file other than the addition of new content since the last release.

The Updates.mdb file will be removed in a subsequent release. It covers more fields than the Updates.csv file. This additional granularity will be replaced in a corresponding CSV file.

RELMA Changes

For RELMA versions 7.9 and older, the online search, powered by Apache SOLR service, will be retired on Dec. 31, 2024. Users are strongly encouraged to:

1. Update to the latest version of RELMA, or
2. Switch to RELMA's internal Lucene search.

More information and instructions on making that change are available in the LOINC Knowledge Base.