LOINC Version 2.64 and RELMA Version 6.23 are now available

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LOINC 2.64
Released 2018-06-15

RELMA 6.23
Released 2018-06-15

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:

  1. LOINC content highlights
    1. New content
    2. Content edits
  2. Highlights of updates to other LOINC release artifacts
    1. New LOINC Display Name File
    2. LOINC Answer File
    3. LOINC Group File
    4. LOINC Part File
    5. LOINC/RSNA Radiology Playbook
  3. LOINC Linguistic Variant Updates
  4. Changes to the public LOINC data files in this release
    1. New approach to versioning LOINC artifacts
    2. Pascal Case
    3. LOINC Panels and Forms File
    4. LOINC Linguistic Variants File
    5. LOINC Top 2000+ Lab Observations
  5. Notice of upcoming changes to the public LOINC data files
    1. New CSV format for LOINC Panels and Forms File
  6. RELMA release highlights
    1. Improved feature to export full Panels and Forms structure to Excel

Read on for the full details.

Highlights from the latest LOINC release

New content

LOINC version 2.64 contains 87863 terms, an increase of 1335 since version 2.63. Overall, this release includes 525 new laboratory, 321 new clinical, and 489 new survey terms.

Some of the new content highlights in this version:

  • Over 200 new microbiology terms
  • Approximately 40 new terms in each of the CELLMARK and DRUG/TOX classes
  • Approximately 30 new terms each in the ABXBACT and CHEM classes
  • Over 60 terms with the new Method Line blot
  • More than 100 new Document Ontology terms. Sixty-three of these terms are separate Obstetric note and Gynecology note terms.
  • Two TRIAL panels for reporting "high sensitivity" cardiac troponin T and troponin I results along with the key information needed to interpret the quantitative results:
  • Fifteen panels for the Nomenclature des Actes de Biologie Medical (NABM), the official listing of biomedical procedures in France. The NABM is defined by the Caisse nationale de l'Assurance Maladie des travailleurs salaries (CNAMTS; the French National Health Insurance Fund for Salaried Worker)
  • Current representations of CMS Long-Term Post-Acute Care (LT-PAC) assessments as well as versions of some assessments that will be released by CMS in the coming months:
    • Outcome and assessment information set (OASIS) form - version D 88372-8
    • Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 2.0 88329-8
    • Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.15.1 88278-7
    • Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.16.1 88956-8
  • New clinical and survey panels, including:
    • ADAPTABLE patient reported item set 89070-7
    • International Physical Activity Questionnaire
      • International Physical Activity Questionnaire self-administered long form 88379-3
      • International Physical Activity Questionnaire telephone short form 88412-2
      • International Physical Activity Questionnaire telephone long form 88434-6
    • Everyday Cognition panels
      • Everyday Cognition - Study Partner Report Form 89090-5
      • Everyday Cognition - Participant Self Report Form 89133-3
    • Patient Health Questionnaire-9: Modified for Teens 89206-7
    • Timed Up and Go test & physical findings of gait panel 89422-0
    • Rose Dyspnea Scale panel 89440-2
    • Pulmonary Embolism Rule-out Criteria panel 89544-1
    • Wells pulmonary embolism risk calculator panel 89546-6
    • Revised Geneva Score panel 89549-0
    • Comprehensive Universal Behavior Health Screen 89556-5
    • Exercise Vital Sign (EVS) 89574-8
    • Beck Depression Inventory panels
      • Beck Depression Inventory II 89210-9
      • Beck Depression Inventory Fast Screen 89211-7

Edits contained in this release

This release contains a total of 2964 deprecated terms, of which 44 were deprecated since version 2.63. In addition, about 3700 terms have been edited.

Changes based on internal review or as part of an ongoing project

  • Updated Method from IA to Line blot for nearly 100 terms that were created for assays that include electrophoresis as part of the manufacturing step but not as part of the laboratory assay performed on the patient sample.
  • Updated Short Name for over 2100 Radiology terms for improved readability
  • Updated Component and/or System for nearly 300 Radiology terms as part of our final transformations into the LOINC/RadLex unified model
  • Added the word serogroup to the Component of approximately 100 Neisseria meningitidis terms that specify a serogroup, in order to avoid ambiguity in the nomenclature
  • Removed more parentheses that were around the gene name in the Component for several microbiology terms. This is a work in progress and more terms will be updated for the next release.
  • Updated the structure of the Wound assessment panel 39135-9 within the Nursing physiologic assessment panel 80346-0 per the LOINC Nursing Subcommittee
  • Discouraged 32 combined Obstetric and Gynecology note terms based on LOINC Document Ontology Subcommittee review

Changes based on community input

  • Updated the System for approximately 50 terms from Ser or Plas to Ser/Plas
  • Updated OrderObs for several terms from Order to Both
  • Added HL7_ATTACHMENT_STRUCTURE and ValidHL7AttachmentRequest attribute values to Periodontal Attachment request 74030-8
  • Corrected log to natural log (ln) in the FORMULA for the 2-year kidney failure risk 85624-5 and 5-year kidney failure risk 85625-2
  • Corrected the name of the nucleic acid segment in the Component for Bordetella parapertussis IS1001 DNA 87621-9
  • Reviewed duplicate entries and inconsistencies in the Top 2000 Common Lab Results file that were reported by a LOINC user

Updates to other release artifacts

NEW LOINC Display Name File

We are delighted to announce the inaugural release of the LOINC Display Name artifact. Our work to create more human friendly display names for LOINC terms has been a multi-year journey with input from many LOINC users. We are pleased with the outcome in this first version, but also welcome your feedback.

This first release of the LOINC Display Name File contains 54758 rows of data, which represent all Type 1 (Laboratory) terms in LOINC. The Display Name for each term is created algorithmically based on the set of primary rules documented in the associated Readme notes.

In this Alpha release, the Display Name for nearly all Laboratory LOINC terms with Status of DEPRECATED is simply Deprecated or in a few cases the Display Name begins with the word Deprecated. We included these as a placeholder so that all Laboratory terms are represented. The Display Name for deprecated terms may change in future releases. The Display Name for non-deprecated terms may also be updated in future releases.

In the future, we anticipate developing a mechanism to link abbreviations used in these Display Names (and other LOINC names) with their more complete or fully elaborated representations. This would likely be done using LOINC Parts.

LOINC Answer File

The release has been upgraded from version "Beta.1" to "Beta.2". We have received no significant public comments about its structure and have not identified any major format changes needed at this time. We are continuing to evaluate our approach to linking a LOINC term to multiple answer lists, and would like additional user feedback before moving this artifact to production status.

For more information, see the specific Release notes and Readme documentation included with this file.

LOINC Group File

This 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.

We have added contents in several domains, including Groups of Radiology terms by Region Imaged, Document Ontology Groups based on the Setting, and several Groups based on a broader clinical concept, such as Social Determinants of Health and physical activity.

We also added more Group-level attributes, including UsageNotes and Component-level molecular weights from the PubChem database for nearly 900 Groups. An additional Status attribute value of Inactive was created for ParentGroups and Groups (see the associated Readme for the Status definitions).

For more information, see the specific Release notes and Readme documentation included with this file.

LOINC Part File

The release has been upgraded from version Beta.1 to Beta.2. We have received no significant public comments about its structure and have not identified any major format changes needed at this time.

We are continuing to evaluate our approach to linking LOINC Terms to Parts, including for suffixes, divisors, and core components. Before moving to production status, we would like further testing and feedback about these approaches.

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 represents the success of 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.

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 3.15.

The parsing issues that existed in the previous release have been fixed, and missing LOINC Radiology Parts have been added. However, some (less than 30) of these new Parts do not have mappings to RadLex RIDs; these will be added in the next LOINC release.

For more information, see the specific Release notes and Readme documentation included with this file.

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:

  1. de_AT_24 - German (AUSTRIA)
  2. es_ES_12 - Spanish (SPAIN)
  3. fr_CA_8 - French (CANADA)
  4. fr_FR_18 - French (FRANCE)
  5. nl_NL_22 - Dutch (NETHERLANDS)
  6. zh_CN_5 - Chinese (CHINA)

NOTE Users should note that we intend to retire the translations produced by CUMUL in a future release. That translation effort was suspended many years ago and more comprehensive translations into French, German, and Italian have been produced by others.

Notice of changes to the public LOINC data files in this release

New approach to versioning LOINC artifacts

The Clinical and Laboratory LOINC Committees previously approved a new approach to versioning LOINC release artifacts for implementation in the June 2018. We have implemented this new versioning policy and naming conventions in this release.

The new versioning policy follows a <major>.<minor> style, with the first version digit corresponding to structural changes and the second digit to content changes. Additionally, the file names for release artifacts will include both 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 previously announced in June 2017, we have also applied the Pascal Case naming style to existing files within this LOINC release distribution.

Some of the changes include:

  • loinc.csv was renamed Loinc.csv
  • map_to.csv was renamed MapTo.csv
  • source_organization.csv was renamed SourceOrganization.csv
  • loinc.mdb file was renamed Loinc.mdb

Within the Loinc.mdb Access database, the legacy tables have been renamed as follows:

  • LOINC table was renamed Loinc
  • MAP_TO table was renamed MapTo
  • SOURCE_ORGANIZATION table was renamed SourceOrganization

LOINC Panels and Forms File

As previously announced, in this release, the LOINCS and ANSWERS tabs have been eliminated from the PanelsAndForms spreadsheet in order to unify the format with the Answer File and reduce redundancy across files. The data that were formerly available in the LOINCS tab are available in the main LOINC File. The information from the ANSWERS tab is available in the improved format of the AnswerFile artifact, which contains two main data files: AnswerList and LoincAnswerListLink.

In this release we also added a new field, EXTERNAL_COPYRIGHT_NOTICE, to the FORMS tab. This field contains external copyright holder's copyright notice for the LOINC term, if applicable.

LOINC Linguistic Variants File

We have added a new LinguisticVariantDisplayName field to all of the linguistic variants files. The Linguistic Variant Display Name is a translation of the LOINC term as a whole. It is somewhat analogous to the LONG_COMMON_NAME, except the style and format is left up to the translator and it is not a direct translation of any of the formal LOINC Parts or Names.

LOINC Top 2000+ Lab Observations

KNOWN ISSUE A handful of terms are duplicated in different sections of the Top 2000 Common Lab Results file, and in some cases with different rankings. This likely occurred when the replacement terms for DEPRECATED terms already existed in the file, but in a different place and with a different ranking.

Given the inconsistencies and the fact that the file is difficult to maintain, we plan to freeze the current version of the top 2000 in its current state and are exploring new ways to present the data as well as updating the information based on recent data on lab test frequency.

Notice of changes to the public LOINC data files for the December 2018 Release

New CSV format for LOINC Panels and Forms File

In a future LOINC release (i.e., December 2018), we intend to distribute the content of this artifact in a CSV format rather than as an Excel spreadsheet. The CSV text format has become LOINC's default format for data files, so this change will improve consistency across the LOINC artifacts.

In addition, we are contemplating bundling the main panels and forms CSV file with , Loinc.csv, AnswerList.csv, and LoincAnswerListLink,csv into a single package. This would provide users with all the artifacts relevant to a complete form. We invite comment on whether that would be helpful or if you prefer to keep the artifacts separate.

RELMA version 6.23

Improved Export full panel structure to Excel function

The function that exports the full panel structure to Excel has been improved. With this function, RELMA generates a spreadsheet that now contains 4 tabs instead of the previous 3 tabs. The new AnswerList and AnswerListLinks tabs now match the format and structure of the LOINC release artifacts with the same names (contained in the LOINC Answer File).

This improved function enables export of panel-specific bindings of LOINC observation codes to LOINC Answer Lists. The mechanism for panel-specific bindings was implemented in the June 2017 LOINC release and allows a single LOINC term to be linked to multiple answer lists with different binding strengths defined in the context of a given panel. See the LOINC Users' Guide section on LOINC Answers (LA) and Answer Lists (LL) for more information.