In this Update
We are delighted to present you with another feature-packed LOINC release. There’s a lot to cover, but here’s the outline:
- LOINC content highlights
- New content
- Content edits
- Highlights of updates to other LOINC release artifacts
- LOINC Answer File
- LOINC Group File
- LOINC/IEEE Medical Device Code Mapping Table
- LOINC Part File
- LOINC/RSNA Radiology Playbook
- LOINC Linguistic Variant Updates
- Changes to the public LOINC data files in this release
- Notice of upcoming changes to the public LOINC data files
- June 2018 Release
- New approach to versioning LOINC artifacts
- Pascal Case
- June 2018 Release
- RELMA release highlights
- New feature to filter search results by a user-defined subset of LOINC terms
- Improved (but not perfect) support for high resolution monitors
- Updated .Net framework
Read on for the full details.
Highlights from the latest LOINC release
New content
LOINC version 2.63 contains 86,528 terms, an increase of 1,660 since version 2.61. Overall, this release includes 736 new laboratory, 558 new clinical, and 366 new survey terms.
Some of the new content highlights in this version:
- Over 300 new microbiology terms
- Approximately 200 new drug/tox terms, including those for human and veterinary testing
- 50 new chemistry terms
- New panels for laboratory terms, including:
- Dengue virus 1+2+3+4 and Zika virus IgA+IgG+IgM panel – Unspecified specimen by Immunoassay 87441-2
- Borrelia burgdorferi Ab and Anaplasma phagocytophilum, Babesia microti and Ehrlichia chaffeensis IgG panel – Serum 87547-6
- Neutrophil cytoplasmic Ab.IgG and Saccharomyces cerevisiae IgA and IgG in Serum 87551-8
- Veterinary toxicology panels for Carbamates 87670-6, Chlorinated hydrocarbons 87669-8, and Organophosphates 88032-8
- Nearly 350 new radiology terms, including new terms with the Method “{Imaging modality}” for modality-agnostic procedures to complete the harmonization between the RSNA Playbook and LOINC Radiology
- Approximately 50 Document Ontology terms
- Updated patient assessment instruments as part of our ongoing collaboration with CMS:
- Minimum Data Set (MDS) – version 3.0 – Resident Assessment Instrument (RAI) version 1.14.1 86521-2
- Outcome and assessment information set (OASIS) form – version C2 86905-7
- Inpatient Rehabilitation Facility – Patient Assessment Instrument – version 1.5 87414-9
- Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) – version 4.00 87505-4
- New clinical and survey panels, including:
- HEDIS 2018 Value sets 87625-0
Edits contained in this release
About 4,300 terms have been edited (see below). This release contains a total of 2,920 deprecated terms, of which 112 were deprecated since version 2.61. One term has been undeprecated since the last release.
Here are some of the editing highlights:
- For terms included in CMS assessment panels, changed CLASS from SURVEY.MDS to SURVEY.CMS.
- Updated the Supersystem so that the first letter is upper case for consistent capitalization across all Supersystems, for example, ^population to ^Population.
- Updated the Preferred Abbreviation (used in the Short Name) and Display Name (used in the Long Common Name) for the following Methods as shown, based on recommendations by the LOINC “PCR-based Methods” Special Topics workgroup, which were approved by the Laboratory LOINC Committee in June 2017:
- Probe
- Preferred abbreviation from Prb to Probe
- Display Name from DNA probe to Probe
- Probe.amp.tar
- Preferred abbreviation from PCR to NAA+probe
- Display Name from Probe and target amplification method to NAA with probe detection
- Probe.amp.sig
- Preferred abbreviation from bDNA to Probe+sig amp
- Display Name from Probe and signal amplification method to Probe with signal amplification
- Non-probe.amp.tar
- Preferred abbreviation from Non-probe PCR to NAA+non-probe
- Display Name from Target amplification with non-probe based detection to NAA with non-probe detection
- Removed the parentheses that were around the gene name in the Component for several terms in the ABXBACT class. This is a work in progress and more terms will be updated for the next release.
- Removed the contents of the DOCUMENT_SECTION field. Because it is too difficult to maintain and because the distinction between documents and sections is not clear-cut nor necessary in most cases, the DOCUMENT_SECTION field has been deemed to have little value. The contents of this field have been set to null in this release in preparation for deletion of the field in the December 2018 release as approved by the Clinical LOINC Committee.
- Updated terms with Component or System of Pressure ulcer to Pressure injury to follow the new National Pressure Ulcer Advisory Panel (NPUAP) guidelines.
Updates to other release artifacts
LOINC Answer File
The release has been upgraded to Beta VersionType because we received no significant public comments about its structure and have not identified any major format changes that are needed.
The Answer list file contains 21735 rows of data representing 3239 unique answer lists and 15198 unique answer strings. There are mappings to 368 unique concepts from external coding systems. The SNOMED CT mappings have been updated based on the July 2017 International Release and the September 2017 US Edition of SNOMED CT, as documented in the ExtCodeSystemVersion field.
The LOINC Answer list link file contains 16741 rows of data representing links between 15966 unique LOINC terms and 3239 unique answer lists. We have significantly enhanced the number of LOINC terms linked to context-specific answer lists; there are now more than 770 such bindings. This approach enables more appropriate re-use of LOINC codes across different panels.
IMPORTANT NOTES: The ApplicableContext field in the LoincAnswerListLink file is now the top most parent panel that has a PanelType = Panel. Previously, the ApplicableContext field was populated with the immediate parent panel, regardless of PanelType.
For more information, see the specific Release notes and Readme documentation included with this file.
LOINC Group File
This release continues to be an Alpha VersionType because we have made significant changes to the structure and contents of the file.
To eliminate redundancy, the release artifact has been split into five .csv files, two at the ParentGroup level and three at the Group level, as described in detail in the associated Readme.
Briefly, the two ParentGroup files contain the ParentGroup Name and Status, and any applicable attributes at the ParentGroup level, respectively. The three Group files contain the relationship between:
- the ParentGroup and the Group;
- any applicable attributes at the individual Group level; and
- the relationship between the Group, Category, LOINC numbers and LOINC Long Common Names, respectively.
We have added contents in several domains, including reportable microbiology, radiology, and Document Ontology. We have also begun adding Group-level attributes, such as a summary of studies comparing point of care glucose testing to that done in the central laboratory, which is attached to two Groups that roll up Glucose testing in any blood, serum, or plasma specimen done by any Method. Over time, we plan to add many more Group-level attributes. For the Alpha 2 release, we have included a handful.
Similarly, we have added an Archetype field in both the Group and GroupLoincTerms files. An archetype term for a specific Group is the most general representative term for that Group. For example, in a Group rolled up by Method, the methodless term is the archetype term. For the Alpha 2 release, we have only added archetype terms in the context of Method rollups, but we plan to add more use cases in future releases.
Beginning with the Alpha 2 release, we expect to persist the LG codes in future versions of the file.
For more information, see the specific Release notes and Readme documentation included with this file.
LOINC/IEEE Medical Device Code Mapping Table
As part of our ongoing collaboration with IEEE, we continue publishing the LOINC/IEEE Medical Device Code Mapping Table. In this release, there are approximately 50 new mappings between LOINC terms and concepts from the IEEE 11073 10101 Nomenclature and 10101a Nomenclature Amendment.
LOINC Part File
The release has been upgraded to Beta VersionType because we received no significant public comments about its structure and have not identified any major format changes that are needed.
For more information, see the specific Release notes and Readme documentation included with this file.
LOINC/RSNA Radiology Playbook
The release of the LOINC/RSNA Radiology Playbook file marks a major milestone in our ongoing collaborative work with the RSNA to develop a unified model for naming radiology procedures. We have now completed the transformation of all of the existing LOINC radiology content into the unified model. We have also now linked all of the core RadLex Playbook terms to corresponding terms in LOINC.
Regenstrief and the RSNA are now transitioning this work into a sustained activity of both organizations.
This version of the LOINC/RSNA Radiology Playbook file contains 40492 rows of data representing 5821 LOINC terms linked to 907 unique LOINC Radiology Parts, which are mapped to 859 unique RadLex RIDs. Out of the 5821 unique LOINC terms, 998 are mapped to 1008 unique RPID concepts from the RSNA Playbook, for a total of 1015 unique LOINC-RPID mappings.
The mappings to and content from the RSNA Playbook have been updated based on version 2.4 of that terminology. Out of the 1008 unique Playbook concepts included in this release, 990 are from the Core Playbook, and the remainder are from the Complete Playbook.
KNOWN ISSUE: During our review process prior to the LOINC 2.63 release, we discovered a handful of missing radiology Parts (primarily View type) as well as a few parsing issues for terms with more than one Reason for Exam or Aggregation value. These will be corrected in the next LOINC release.
LOINC Linguistic Updates
The global community of LOINC users continues to help produce a wonderful collection of translations. For many years we have made these linguistic variants (we support multiple translations of the same language) available in RELMA and in our online search.loinc.org application. You can also download the translations in the LOINC Linguistic Variants File.
Updated Linguistic Variants in this release:
- fr_CA_8 – French (CANADA)
- fr_FR_18 – French (FRANCE)
- nl_NL_22 – Dutch (NETHERLANDS)
- zh_CN_5 – Chinese (CHINA)
- it_IT_15 – Italian (ITALY)
Notice of of changes to the public LOINC data files in this release
LOINC TableCore File
In this release, the field size for all the fields listed below have been expanded to 255. This change was approved in December 2016 by the LOINC Committee and announced publicly according to our established process.
Fields that were expanded to 255 characters:
PROPERTY
TIME_ASPCT
SYSTEM
SCALE_TYP
METHOD_TYP
CLASS
VersionLastChanged
CHNG_TYPE
STATUS
SHORTNAME
VersionFirstRelease
LOINC Table File
In this release, the field size for all the fields listed below have been expanded to 255. This change was approved in December 2016 by the LOINC Committee and announced publicly according to our established process.
Fields that were expanded to 255 characters:
PROPERTY
TIME_ASPCT
SYSTEM
SCALE_TYP
METHOD_TYP
CLASS
VersionLastChanged
CHNG_TYPE
STATUS
SHORTNAME
VersionFirstRelease
LOINC Panels and Forms File
As a reminder to users, in future releases, we intend to unify the representation of LOINC answer lists in the FORMS and ANSWERS tabs of this file with the new structure defined in the AnswerList and LoincAnswerListLink files.
Notice of changes to the public LOINC data files for the June 2018 Release
New approach to versioning LOINC artifacts
The Clinical and Laboratory LOINC Committees have approved a new approach to versioning LOINC release artifacts for implementation in June 2018.
The new versioning policy will follow a <major>.<minor> style, with the first version digit corresponding to structural changes and the second digit to content changes. Additionally, release artifacts will separately label their own version and the version of LOINC that they depend on.
NOTE: Users are encouraged to review the details of this versioning approach at https://loinc.org/versioning
Pascal Case
As announced in June 2017, we will also be applying the Pascal Case naming style to existing files within the LOINC release distribution. Please see the Release Notes from version 2.61 for details.
RELMA version 6.22
New feature to filter search results by a user-defined subset of LOINC terms
RELMA now supports filtering search results by user defined subset. Many countries support a curated, nationally-approved list of LOINC codes for use in their jurisdiction. Rather than search the whole 80,000+ LOINC database, with this new feature, their searches within RELMA are limited to only what they need.
Before you can use this feature in RELMA, you’ll need to define your subset. You can do this by logging into https://loinc.org/subsets.
Once you’ve defined a subset, when you are logged into RELMA, you can go to the user preferences screen and select the subset that you’d like to use as a filter. Then run your search as usual. The results grid will only include LOINC terms that are in your subset list. The “subset” toggle at the bottom of the screen provides an easy way to turn this filter on and off as needed.
Pretty sweet!
Improved (but not perfect) support for high resolution monitors
Historically RELMA has not dealt well with monitors that are set at high resolution and scale factors greater than 96 dpi. With this release we have taken some initial steps in an attempt to address some of the most egregious issues. If you are running at 96 dpi you may notice some additional space added to accommodate certain controls.
Updated .Net framework
RELMA is based on the Microsoft .Net framework. In this release we have upgraded the program to use the latest release of the framework. If a compatible version of the framework is not already installed on your system the installer program should install it for you as a prerequisite. If this upgrade fails for some reason you can manually download and install the .net framework directly from Microsoft. If a new version of the framework is installed on your machine, a reboot will be required.