Logical Observation Identifier Names and Codes (LOINC(tm)) Brief Introduction LOINRDME.TXT Revised: 4/28/96 ----------------------------------------------------------- Please send questions and comments to: Regenstrief Institute c/o Kathy Hutchins 1001 W. 10th St., RG-5 Indianapolis, IN 46202 Internet: loinc@regenstrief.iupui.edu ----------------------------------------------------------- These and other relevant documents are available via FTP/Gopher: dumccss.mc.duke.edu/standards/HL7/termcode/loinclab WWW URL: http://dumccss.mc.duke.edu/standards/HL7/termcode/loinclab/ The file names are: Description File Name ----------- --------- LOINC data base (WP 6.0) LOINDBW1.WP6 uncompressed LOINC data base (WP 6.0) LOINDBW1.ZIP PKZIPped LOINC data base (ASCII) LOINDBT1.TXT uncompressed LOINC data base (ASCII) LOINDBT1.ZIP PKZIPped LOINC data base (WinWord 2.0) LOINDBWW.DOC uncompressed LOINC data base (WinWord 2.0) LOINDBWW.ZIP PKZIPped LOINC data base (DBF) LOINCDBF.EXE Self-extracting ZIP file LOINC Users Manual (WP 6.0) LOINMAN1.WP6 LOINC Users Manual (WinWord 2.0) LOINMAN1.DOC LOINC Introduction (ASCII) LOININTR.TXT (this file) LOINC Read Me (ASCII) LOINRDME.TXT ---------------------------------------------------------- Release Notes ---------------------------------------------------------- Version 1.0h Released 8/21/96 1. LOINC News In July 1996, the American Clinical Laboratory Association (ACLA) endorsed LOINC and is now recommending that all of its member report laboratory results using LOINC codes. The 40+ members of the ACLA account for approximately 70% of the volume of tests performed in the United States. Also, ICD10 PCS codes for HCFA are being now constructed based on LOINC terms. 2. Corrections to existing terms 2.1 SUPER Convention Previously we used "LITTLE" in the component/analyte name to indicate that the following alphabetic character is lower case in the official name. In this release we similarly employ the word "SUPER" to indicate that the following character is a superscript according to official nomenclature. 2.2 Blood bank The parentheses included in the names of blood bank antigens were mostly unnecessary. They should not have been included according to our naming rules for specifying lower case alphabetic terms (LITTLE) unless, as in a few cases, the lowercase letter is enclosed by parentheses in the formal name. These have been corrected in this release. 3. Changes to standard report format We have changed the content of the printable (WordPerfect and Word) versions of the LOINC data base in the following ways: The Map-To, ASTM Code, IUPAC Code, MetPath Code, and Comments fields are no longer displayed. They are still maintained in the full database, they are just not printed in the word processing version. Fields representing the Exact Core Component Synonym, Change Reason, IUPAC Analyte Code, and Molar Mass have been added. The order of the fields is now : 1 Status 2 Class 3 Loinc Number 4 Analyte/Component Name 5 Type of Property 6 Time Aspect 7 System/Specimen 8 Type of Scale 9 Method 10 Related Names 11 Exact Core Component Synonym 12 Date Last Changed 13 Reason for Change 14 Answer List 15 EUCLIDES Code 16 IUPAC Analyte Code 17 Molar Mass 4. New data fields 3 new fields have been added and populated with data for many observations: Field # Field Name Type Width 33 EXACT_COR_SYN C 254 34 MOLAR_MASS C 13 35 IUPAC_ANLT_CD C 7 Field 33: Exact core component synonym This field contains an exact synonym for the "core component" of the LOINC component name. We have included the mixed case and "superscript" form of blood bank and HLA antigens (e.g., Lua) here to make it easier for automatic matching programs. As there is no ASCII character for superscript letters, we use the hat (^) to signify that the next character is a superscript in these exact synonyms. (E.g., if the core component is represented as L LITTLE U LITTLE SUPER A in the LOINC component/analyte name field, it is represented in the Exact Core Synonym field as Lu^a.) In a future release we will add more exact synonyms for the core components. Field 34: Molecular weights This field contains the molecular weights of many chemical moieties when they are provided to us. Those added in this release were kindly contributed by IUPAC. Field 35: IUPAC analyte code This field contains the Chemical Abstract service number or the Enzyme Nomenclature number for the chemical components for chemicals and/or enzymes. These were also contributed by IUPAC. 5. New observations We have added 1,559 terms in the following areas: 5.1 Susceptibilities based on antibiotic gradient strips (E- tests) We have added observations to represesnt each of the antibiotics for which susceptabilites can be performed via antibiotic gradient strips. 5.2 Allergen testing: serum IGE and basophil bound antibodies We have significantly enlarged the set of serum IGE allergen tests, and have added a large number of tests for basophil bound antibodies to specific allergens using the leukocyte histamine release method. This test may be more clinically predictive than the serum based IGE allergen tests. Most of these allergen test terms were contributed by Lab Corp and Corning MetPath. We edited the allergen names so that the part of the name that corresponds most closely to the genus comes first, the species comes next, and finer specification comes last. So an IGE AB against Live Oak would be listed as OAK LIVE AB.IGE. The IGE AB against Interior Live Oak would be listed OAK LIVE INTERIOR AB.IGE. If the allergen came from a particular part of the tree (e.g., bark) it would be OAK LIVE INTERIOR BARK AB.IGE. (Of course, common names do not always align well with the corresponding scientific name.) In the future, we will work toward including the Latin scientific name for each of the species represented in these allergen tests in the exact component synonym field. 5.3 Microbiology expansion We have added many terms to the microbiology section to deal with exotic infections, antigens and antibodies against more specific sub species (espescially for viruses), and scattered IGM and IGG measures. Some of these additions were made in response to the CDCs communicable disease electronic reporting project, with which we are cooperating. 5.4 Lymphocyte bound CD antigens Corning MetPath contributed approximately 40 new terms for reporting levels and ratios of lymphocyte bound CD antigens. 6. Databases As announced for the release of Version 1.0g, we now distributed an indexed dBASE version of the database as well as the tab delimited ASCII file, MS Word and WordPerfect printable versions that we have always made available. Not all of the data fields appear on the printable reports. You have to use the ASCII or dBASE version to access the entire database. We have not yet updated the Users' Guide to reflect all of these changes; this will be done in the very near future. 7. Future plans We expect to further expand the LOINC database terms for mycology, blood bank, and other areas based on contributions from colleagues in Canada who will likely adopt LOINC for an Ontario province-wide laboratory data base. We are working on terms for surgical pathology and IE cyto stains. We have a proposal in hand for defining LOINC codes for order sets such as CHEM12. Work is underway to develop LOINC codes for genetic and DNA testing. We will continue to enrich the database with synonyms and related information as it becomes available. Version 1.0g Released 4/28/96 Approximately 100 new terms added in a variety of areas. Drug terms linked to MediSpan 10-digit GPI codes where available in new field GPI_CD. Drugs with multiple GPI entries are linked in GPI_CD_TOTAL. New field REFERENCE contains references to textbook, journal, or other information source which provided information about term. 1.0g is the first release to be made available in DBF format. Version 1.0f Released 12/21/95 Classes VIRO, PROBE, BACT, and SERO terms for infections agents reclassifed as MICRO (microbiology). Approximately 300 new microbiology terms added. Corrections to properties, IUPAC codes, and EUCLIDES codes. Link to Metpath codes corrected. Word and WordPerfect versions of database rearranged to show Metpath code links and make identification of deleted terms easier. Variable order changed in tab-delimited database. Changes documented in new release of Users' Guide. Version 1.0e Released 09/15/95 About 25 corrections to properties to correspond to IUPAC usage. Term 6300-8 added for glucose in amniotic fluid. Nomenclature of parts of name changed to conform more closely to IUPAC: measure = component/analyte; timing = time aspect; specimen = system/sample; precision = scale. Version 1.0d Released 7/14/95 Approximately 350 terms added: allergen IGE tests (these are often called RAST tests, after the commonly used method, but more than one method is used) and coagulation tests -- mostly beginning with the letters P through Z -- which which were inadvertently omitted from Release 1.0a. We have established links between LOINC codes and approximately 1500 Metpath codes. These are mapped in METPATH_CODE. In most instances, we have supplied properties for the records whose property fields were blank. Most of these terms are in the hematology class. We identified a number of duplicate entries. Usually these had quite different names but the names were synonyms. In these cases, one of the duplicates was marked "DEL" in the STATUS field, and the MAP_TO field of that record contains a pointer to the correct record. In every case the LOINC record with the smaller LOINC number was identified as the preferred LOINC record and the other one was marked as a "deleted term." (Records are never actually deleted from the LOINC database, but if a term should no longer be used, the value of STATUS will be set to DEL.) Version 1.0c Released 6/28/95 Two terms with duplicate LOINC Number 5917-0 marked Status="DEL" and reassigned to LOINC Numbers 5932-9 and 5933-7. Version 1.0b Released 6/23/95 Approximately 20 Chemistry terms added. Version 1.0a Released 5/24/95 "MAP_TO" field added to provide mapping to new terms when old terms are marked for logical deletion (we put a "DEL" in the STATUS field to indicate this.) We added 16 coagulation terms to the WP version; these terms were in the 1.0 release of the ASCII database but were mistakenly omitted from the WordPerfect 1.0 release. We marked term 3173-2 (Activated Partial Thromboplastin Time) as STATUS="DEL" because it was a duplicate of term 5898-2 (Coagulation Surface Induced, which carries APTT and Activated Partial Thromboplastin Time as synonyms). In BC (blood count) terms, METHOD=FLOW CYTOMETER changed to METHOD=AUTOMATED COUNT to more accurately reflect lab terminology. Version 1.0 Released 4/24/95 ----------------------------------------------------------------- The LOINC database provides a set of nearly 6000 "universal" names and ID codes for identifying laboratory test results in HL7 and ASTM messages transmitting clinical laboratory results from laboratories to hospital practices and public health clinics. The level of detail in the LOINC definitions will distinguish tests that are usually defined as separate test results within the master file of existing laboratory systems. Laboratories and medical record system users should record the LOINC codes as attributes of their existing master files. Laboratory result producers should use the LOINC codes and names in the OBSERVATION ID field of the ASTM and HL7 OBX segment to identify laboratory results. Then receivers could understand the result messages without expending resources on medical record code mapping. The LOINC database is stored in three different file formats. In each of them the first part of the file contains the copyright notice with permission to use the database for any purpose without charge or written permission. Tab Delimited ASCII: Each record of the database is on a separate line. Each record is terminated by CR/LF, and each field is delimited by a tab character. Fields are enclosed in double quotes ("). Spreadsheets and database programs can easily handle such files, but it would result in an awkward word proecessing document. WordPerfect 6.0 file: This file is formatted to print landscape in a Courier 6 point font. Some of the longer fields float vertically. This will result in an easily read document, but it is basically useless for input into databases or spreadsheets. WinWord 2.0: This file was created by exporting the WordPerfect 6.0 file with a WinWord export filter. It has been loaded into WinWord and examined; the translation is usable but not perfect. If your system does not contain the fonts used in the original file, the columns may be misaligned. Consult the Word for Windows Help topic "Improving compatibility with a document created in a different file format" for hints on dealing with this. Import of this file into Word for DOS has not been tested. Each of these files is available both zipped and unzipped. PKUNZIP v. 2.04 or compatible required) The LOINC Users Guide is also available as a WordPerfect 6.0 or WinWord 2.0 file. This Users Guide explains the structure of the database, its rationale, and the rules we used for naming test results. It is not compressed. The Winword file, like the WinWord database file described above, was created with the WordPerfect export filter, and like the database file, it is usable but not perfect. In particular, table of contents tags are replaced with "ERROR: BOOKMARK NOT FOUND" and the automatically generated section numbers are incorrect. Tables are sometimes misaligned but are still readable. See the preceeding paragraph for font translation information. Import of this file into Word for DOS has not been tested. The introduction to the Users Guide is available as a separate ASCII text file. LOINC Committee Members: Clement J. McDonald, M.D., Chairman Regenstrief Institute and Indiana University School of Medicine, Indianapolis IN John Baenziger, M.D. Indiana University Hospital, Indianapolis, IN Linda Charles, Ph.D. Quintiles, Morrisville, NC Georges DeMoor, M.D. University Hospital Ghent, Ghent, Belgium Diane Dwyer Maryland Dept. of Health and Mental Hygiene, Baltimore, MD Tom Fiers, M.D. University Hospital Ghent, Ghent, Belgium Arden Forrey, Ph.D. University of Washington, Seattle, WA Andrew Gajda Laboratory Corporation of America, Raleigh, NC Brian Griffin MetPath Labs, Westwood, MA Stan Huff, M.D. IHC/Primary Children's Medical Center, Salt Lake City, UT Dennis Leavelle, M.D. Mayo Medical Laboratories, Rochester, MN Diane Leland, Ph.D. Riley Hospital for Children, Indianapolis, IN Doug Martin, M.D. Roudebush VA Medical Center, Indianapolis, IN Frank Stalling, M.D. Dallas ISC Dept.of Veterans Affairs, Grand Prairie, TX John Stelling World Health Organization, Geneva, Switzerland Anders Thurin University Hospital, Linkoping, Sweden William Thurston Associated Regional and University Pathologists, Salt Lake City, UT Wayne Tracy SpaceLabs Medical, Inc., Overland Park, KS Ann Tullis Indiana University Hospital, Indianapolis IN Larry Widman University of Oklahoma Health Sciences Center, Oklahoma City, OK