Current versions of LOINC and RELMA released December 22, 2014.
Highlights from our best LOINC release yet
New content
LOINC version 2.50 contains 74,600 terms, an increase of 711 since the June 2014 version. Approximately 4640 terms have been edited, excluding edits to the LOINC.RELATEDNAMES2 field (see our note about this below). A total of 2216 terms have been deprecated.
This release includes over 350 laboratory, 170 survey, and 170 clinical new terms.
Some of the new content highlights in this version:
- Over 130 new molecular pathology terms, including terms for non-invasive prenatal testing
- 43 new terms for microbiology testing, including Ebola Zaire PCR (75411-9), HIV 1+2 Ab & HIV1 p24 Ag rapid EIA (75666-8), and Enterovirus D68 RNA (76072-8)
- Over 80 new clinical document codes added to the Document Ontology
- New panels/sets for laboratory tests, including:
- Gram negative blood culture panel (75673-4)
- Electrolytes 3 panels for 24 urine (75667-6) and CSF (75641-1)
- Hepatitis A virus RNA & Parvovirus B19 DNA panel (75860-7)
- Two Lupus anticoagulant screening panels, one with dRVVT and aPTT as the screening tests (75515-7) and the other with dRVVT, aPTT, and PT (75881-3)
- Noninvasive fetal testing panels for aneuploidies and microdeletions based on analysis on cell-free DNA and maternal WBC DNA (75547-0)
- Sterols panel (MCnc) (75858-1)
- Rheumatoid arthritis disease activity panel (75635-3)
- Over 150 terms created for the following survey/assessments: ADVault, AIS, COOP, HAQ, HAQ-II, HAQ-DI, NMMDS, PAS, PAS-II, and PROMIS
- Terms created for Patient-Centered Outcomes Research Institute (PCORI) and the PCORnet Common Data Model (CDM)
- Terms created for HL7 CDA implementation guides, including Consolidated CDA and National Ambulatory Medical Care Survey (NAMCS)
- HEDIS 2015 Value Sets (75868-0)
- Meaningful Use sets for HIV and HCV (75622-1, 75888-8, 75887-0, and 75886-2)
Other edits contained in this release:
- Updated Apolipoprotein E chemistry and genetics terms to clarify their meaning
- For terms with a property of ‘TmStp’ that report the date only, the Property has been changed from ‘TmStp’ to ‘Date’
- For terms reporting a risk (e.g. Trisomy 21 risk), the property is now ‘Likelihood’
- For terms reporting a score (either based on a scale or total score), the property is now ‘Score’
- Class DOC.CLINRPT changed to DOC.ONTOLOGY, a more representative name for all clinical documents, not just clinical reports
- Method of {Provider} changed to {Author Type}, a more inclusive name for any author of a clinical document, not just clinical care providers
- Many example and UCUM units added to non-lab quantitative terms (in clinical and survey classes)
- We are in the process of updating answer list names and descriptions to better reflect their content.
- New conditionality options, such as “Required with alternative” and “Reflex”, for the individual terms in panels that represent complex testing algorithms.
- New answer list type of “PREFERRED”. Preferred lists contain a set of answers that users are strongly encouraged to use. They represent a recommended set, however alternate result values may be used if necessary.
- For terms with an additional third party copyright, we have aligned the content in the EXTERNAL_COPYRIGHT_NOTICE field of the LOINC table with the COPYRIGHT and TERMS_OF_USE fields in the Source Organization table.
A note about edited terms and change types in this release:
- As part of internal database improvements, we cleaned up some content in the RELATEDNAMES2 field of the LOINC table and reordered the related names into alphabetical order. As a result, nearly every record in the LOINC table was updated. Since the content is essentially the same, we did not flag these edits with a change type of ‘MIN’.
New and improved “LOINC and RELMA Complete Package”
In past releases, this file contained the RELMA setup file and all the formats we published of the LOINC Table. We’ve now added a whole bevy of other Accessory Files that we distribute along with the core LOINC content. We felt that it was about time to wrap all that goodness into one bundle. So, for this release and going forward, our “Complete Package” will include the RELMA® program installer and all of the core LOINC® files, including the LOINC® Table (all formats), documentation, and all accessory files.
Notice of of changes to the public LOINC data files in this release
This release includes one change to the structure of the LOINC Table:
Field Name: LOINC.EXTERNAL_COPYRIGHT_LINK
Formal Definition: For terms with an additional third party copyright, this field is populated with the COPYRIGHT_ID from the Source Organization table (see Table 28c in the LOINC Manual).
Action: Add
This release includes several changes to the structure of the LOINC panels and forms file. We have added the following fields for more complete representation of survey instruments and forms:
Field Name: FORMS.QuestionCardinality
Formal Definition: Controls the cardinality of a question on a form. The lower range will be 0 for optional questions or 1 for mandatory questions. The upper range is a number > 0. This value indicates number of times that this question can be asked. “*” is used as a special flag to indicate that there is no upper bound.
Action: Add
Field Name: FORMS.AnswerCardinality
Formal Definition: Controls the cardinality of the answers on a form. The lower range will be 0, indicating that the user is not required to answer the question, or 1, indicating that the user is required to answer the question. The upper range is a number > 0. This value indicates number of answers is allowed. “*” is used as a special flag to indicate that there is no upper bound.
Action: Add
Field Name: LOINCS.EXTERNAL_COPYRIGHT_LINK
Formal Definition: For terms with an additional third party copyright, this field is populated with the COPYRIGHT_ID from the Source Organization table (see Table 28c in the LOINC Manual).
Action: Add
Field Name: ANSWERS.Description
Formal Definition: Detailed description for an answer
Action: Add
Field Name: ANSWERS.Score
Formal Definition: Score value for the answer. Used in instruments where response values are used to calculate one or more scores.
Action: Add
Field Name: ANSWERS.SubsequentTextPrompt
Formal Definition: Text that should be displayed when a user chooses this answer. A value in this field indicates that choosing this answer should result in the user being prompted to provide an additional free text input, e.g. “Other, please specify”.
Action: Add
Field Name: ANSWERS.AnswerListId
Formal Definition: The LOINC answer list ID. Answer list IDs begin with ‘LL’ followed by a numeric identifier, e.g. LL512-5.
Action: Add
Field Name: ANSWERS.AnswerListName
Formal Definition: The descriptive name for an answer list. (As mentioned above, we are in the process of updating answer list names to better reflect their content).
Action: Add
Minor Updates to the Top 2000
Along with this release , we’ve also published an update to the Top 2000+ US and SI versions to replace a few Deprecated terms.
Notice of discontinuation of separate Panels and Forms files for the June 2015 release
For some time we’ve been publishing various subsets of LOINC panels and forms for separate download. (There’s also one file that has all of them wrapped up into one, and we’ll still distribute that file). Very few of you download these separate subsets, and they are extra overhead for us to produce. So we’re going to stop. Also, since version 6.0 RELMA has had the ability to create these exports on the fly for any individual panel or collection of panels you wish.
Notice of of changes to the public LOINC data files for the December 2015 release
Field Name: ANSWERS.CODE_SYSTEM_OID
Formal Definition: The Object Identifier (OID) for the answer list. This OID may be assigned by Regenstrief or another Registration Authority.
Action: Rename to ANSWER_LIST.OID
Discussion: The current name implies that the OID for the value set is tied to a specific code system. In fact, the OID identifies the value set (answer list), not the code system from which individual answer codes in the list is drawn. An answer list can be comprised of codes from a single code system or, in some cases, it can include codes from multiple code systems. (This structure of codes from multiple code systems in a single list is supported by FHIR.) Changing the name will help to disambiguate the purpose of the field. This field is contained in the LOINC panels and forms file.
Field Name: LOINC.FORMULA
Formal Definition: Contains the formula in human readable form, for calculating the value of any measure that is based on an algebraic or other formula except those for which the component expresses the formula. So Sodium/creatinine does not need a formula, but Free T3 index does.
Action: EXPAND from text (255) to memo
Discussion: The LOINC content developers have been jumping through hoops to make some formulas fit the field limit (255 characters). Truncating or unnecessarily fiddling with formulas to fit the field limit makes things harder than it needs to be for both LOINC staff and LOINC users. Expanding the size of this field will give us the space needed to properly document the formula.
As an example, here is a formula that currently is 472 characters long:
“GT = BetaT * (DT + [TSH]) * (1 + K41 [TBG] + K42 [TBPA]) * [FT4] / (AlphaT * [TSH]) or GT = BetaT * (DT + [TSH]) * [TT4] / (AlphaT * [TSH]) from serum or plasma concentrations of thyrotropin (TSH) and free (FT4) or total (TT4) thyroxine and some constants (AlphaT = Dilution factor for T4: 0.1 l 1; BetaT = Clearance exponent for T4: 1.1e-6 sec-1; K41 = Dissociation constant T4-TBG: 2e10 l/mol; K42 = Dissociation constant T4-TBPA: 2e8 l/mol, DT = EC50 for TSH: 2.75 mU/l)”
Field Name: LOINC.DATE_LAST_CHANGED
Formal Definition: Date last changed.
Action: DELETE and add a “VersionLastChanged” field.
Discussion: The exact date a LOINC term was edited by Regenstrief staff is unnecessary for LOINC users and actually difficult for us to maintain accurately. We know that the dates there now are not 100% accurate. We believe the most helpful thing for users would be a “LOINC Version Number When Last Changed” field. We plan remove the DATE_LAST_CHANGED field and insert a “VersionLastChanged” field.
RELMA version 6.6
LMOF Backup and Restore Features
RELMA now has a complete set of features for backing up and restoring your LMOF (local master observation file…i.e., where you store your mappings). Automatic backup is turned off by default, but can be super handy.
Big enhancements to local term Tagging feature
We have made some great improvements to the tagging feature. Here are some of them:
- Assign a tag to multiple local terms.
- Assign a tag during the import process.
- Exporting of local terms now includes the tag value(s).
With these new features, you can much more easily support a custom multi-user workflow because you can effectively partition a large set of terms.
Enhancements to the search grids
Answer list information for a given term now available on search grids:
- AnswerList: True/false field that indicates whether or not a term has an associated answer list
- AnswerListId: Field allows for searching by LOINC answer list number (LL* code).
- AnswerListName: Field allows for searching by keywords in the answer list name
Other updates and improvements
- Updated “Propose a LOINC” screens to highlight information we need to process a request
- Added a listing of the Classes that a given Part is used in to the Part Search screen
- Other tweaks (see the RELMA Release Notes)
Language Translations
Updated in this release
- French (Canada)
- Italian (Italy)
- Russian (Russian Federation)
- Simplified Chinese (China)
- Spanish (Spain)