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Acknowledgements
LOINC Development Team
LOINC Committee
Supporters
Overview of LOINC
Reviewing new RELMA features!
Installing RELMA
Setting personal preferences
Loading a Local Observation File (LMOF)
Searching for a LOINC Term
Preparing LMOF for Mapping
Review of Map Screen Functions
Setting Search Limits
Mapping Local Terms to LOINC
Viewing LOINC Term Details
Proposing/Submitting New LOINC Terms
Exporting/Printing Mapped Terms
Mapping your own LMOF data
2014 Regenstrief Institute and James Case
Levels of Interoperability
Basic allows data to be exchanged between
computer systems
Comparability
Meaning of the data is consistent when shared
among different parties
Detailed General
General Detailed
2014 Regenstrief Institute and James Case
The Problem
In attempting to arrive at the truth, I have applied
everywhere for information, but in scarcely an
instance have I been able to obtain hospital
records fit for any purpose of comparison. If they
could be obtained, they would enable us to
decide many other questions They would show
[subscribers] how their money was being spent
[and] what amount of good was really being done
with it
Florence Nightingale - Notes on a Hospital, 1873
Test comparisons
What you see in the order list
Lab A
Lab B
Why LOINC?
Within one laboratory, local jargon terms
may be used which are usually well
understood between colleagues, but
would not be sufficiently widely known for
communication with the outside world.
U. Forsum et al., Pure Appl. Chem 72:555-745, 2000 Properties and Units in the Clinical
Laboratory Sciences Part VII. Properties and Units in Clinical Microbiology
2014 Regenstrief Institute and James Case
LOINC 101
Emphasis on Laboratory
LOINC
LOINC Code
5193-8
Hepatitis B virus surface Ab
ACnc
Component
Property Measured
Pt
Timing
Ser
System
Qn
Scale
EIA
Method
Testing instrument
Specific details about the specimen
Priority (e.g. STAT)
Where testing was done
Who did the test
Test interpretation
Pricing or cost
Anything not part of naming the test
Things from other fields in an HL7 artifact
2014 Regenstrief Institute and James Case
Component/Analyte
The substance or entity that is measured,
evaluated, or observed
Sodium
- Glucose
- Brucella sp. organism
- Influenza A Virus antigen
- Cytomegalovirus Virus antibody
- Lipids.Total
-
Component Structure
Analyte Name^Challenge^Adjustments
Formal analyte name
Calcium
Specify subanalytes
May have subclasses
Challenge
Two parts separated
by post
Adjustments
Coronavirus Ag
Calcium.ionized
Adjusted to pH 7.4
Property
the most difficult LOINC axis
Property
the most difficult LOINC axis
PR vs PRID
Timing*
The interval of time over which the observation or
measurement was made
Pt - at a point in time
12H - a twelve hour collection
24H - a twenty four hour collection
System
The system (context) or specimen type upon
which the observation was made.
Ser
Ser/Plas
Bld
Ur
Flu
Tiss
XXX
serum
serum or plasma
whole blood
urine
body fluid
tissue
specified elsewhere
5193-8:Hepatitis B2014
virus
surface Ab:ACnc:Pt:Ser:Qn:EIA
Regenstrief Institute and James Case
System Structure
System^Super System
Super System
818-5:A Ag:ACnc:Pt:RBC^BPU:Ord:
54417-1:ABO+Rh group:Type:Pt:Bld^fetus:Nom:
Scale
Qn
Quantitative
continuous numeric
can have operators (<,>)
Ord Ordinal
Ranked set (1+, 2+, 3+)
Nom Nominal
unranked collection
Taxonomy (e.g. bacteria)
Nar
Narrative
5193-8:Hepatitis B2014
virus
surface Ab:ACnc:Pt:Ser:Qn:EIA
Regenstrief Institute and James Case
Scale (Special)
OrdQn Ordinal or Quantitative
Method
Only needed if interpretation affected
Agglutination
Enzyme Immunoassay
Probe with target amplification
5193-8:Hepatitis B2014
virus
surface Ab:ACnc:Pt:Ser:Qn:EIA
Regenstrief Institute and James Case
Hierarchies
LOINC Class
one
per term
arbitrarily assigned
What is in LOINC?
Content
Term structures
Submitted units, Example UCUM units
Synonyms
Answer lists (increasing number)
Text descriptions links to info sources
about individual tests
Panel structures
Foreign language translations
RELMA
Purpose of Tutorial
Eliminate need to read the Users Manual
Become familiar with RELMA features
Provide some insight into mapping tips/pitfalls
Help begin the mapping process for your
institution
Hang with some really cool folks
RELMA Functions
LOINC files and indexes
Manual and automated mapping functions
RELMA tools transform local words in local file
RELMA Highlights
Browse-able hierarchies of LOINC parts
Display search results in tree view
Enhanced details view of terms/parts
References
Descriptions
Sample units
Installing RELMA
Installation Steps
Requires Windows (or VM on a Mac)
Make sure you have enough free disk space!
2Gb is recommended
File Locations
Database and Ancillary Files
Sample files
Running RELMA
Version 6.9
Copyright Screen
LOINC crowdsourcing
All Spanish!
File Locations:
(See prior slide for location)
Startup Screen Preference
Importing Local
Terms into RELMA
Battery/Panel Code
Battery/Panel Description or Name
*Local Code
*Test Description or Name
Units
Example Values
Laboratory Section
Local Code
Local Description
Units (highly recommended)
2014 Regenstrief Institute and James Case
Manual Enter/Edit
View/Add/Edit Local Terms
Edit\Add\Delete Terms
Export Terms
User assigned tags
Text alignment option
Delimiters supported:
Tab, comma, semicolon, bar (|)
BUBPLAG
BUBONIC PLAGUE RRT PCR
Add tags
Click to Add to Current
Working File
Calcium
Import Button
Fields Segregated
Ready to Import
Minimum assignments
Import tags
You can include tags in your import file
that allow you to categorize your local
terms
Fields in import function allow assignment
of Tag with
Tag terms
Imported tags
OBR ID
OBR description
OBX ID
OBX description
Sample of results with
Real values
Units
Abnormal flags
Normal ranges
2014 Regenstrief Institute and James Case
Skip import of
sample values
Name the Local Term
File (working set)
Import_Sample_OBR.txt
Sample_HL7.HL7
Assign
Replacement
LMOF Attribute
Options
Term Substitution
Comprehensive Search
Only Tool
Search Window
Help File
Enter Search
Terms
Limit to
Specific Units
Use different
logic
Restrict Limits
Search Window
Context Menu
Large number of
Restricting to Common
results
labs refines further
Keyword
ComponentWordCount
restricts word count
Large number of
results
Answerlist details
Welcome Screen
Select the subset of terms to work with:
All
Mapped
Unmapped
Set your Search Limits
Button
Customizable grid
View details of LOINC term
New! Add searchable tags to local term
Sort by column
Click column
Custom Sort
Mapping Screen
View or edit local term
User assigned tags
Configure Grid
Select elements to display
Begin a search
(or hit enter)
EEK! Whatll I
do?!
Click to
show words
used in
search
2014 Regenstrief Institute and James Case
Use term
checkbox
Number of LOINC
terms containing
keyword
Battery terms
included in
search
Number of
matching
records found
Number of
matching
records found
Match units
selected
Navigate through
the local terms
Navigate to Functions
from Mapping Page
Tree View
Tree View
Results displayed hierarchically
Tree View
Cannot map to
terms
representing
LOINC parts
Tree Navigation
Buttons
(or doubleclick)
If comments
option is selected,
prompt appears
LOINC Term
Assigned
Panel Children
Output Options
Include
column headers
Save Configuration
and/or Export
LOINC code
AnswerListID
Answer String
Answer tab
More on Searching
Search Screen
Example
Definition
Influenza virus A
AND
Morphine AND
Opiates
OR
Influenza OR
Parainfluenza
NOT
Gluc?se
(glucose,glucase)
Gluc*se
(glucose,
glucuronidase, etc.)
Search Qualifiers
Exclude Glucosidase
Description
()
Fieldname:
Fieldname:()
{}, []
91 terms
33 terms
19 terms
2014 Regenstrief Institute and James Case
8 terms
2014 Regenstrief Institute and James Case
Limiting Searches
Toggle Buttons
Search Constraints
Attribute trees
Expanded predefined,
general search constraints
Specimen
constraints
CSF
Enter default
Specimen
Exclude laterality
Exclude laterality
Laterality terms
Restrict to
common orders
Common orders
rank
Large number of
candidates
Methodless Terms
Restriction
Only Methodless
Terms Appear
2014 Regenstrief Institute and James Case
Only Methodless
terms returned
Differ in one or
more components
Conditional Methodless
More terms
returned
No method-less
term; all shown
Order/Observation Restriction
Order or Observation
preference
Three top-level
branches
Tree Navigation
Buttons
Large number of
candidate terms
2014 Regenstrief Institute and James Case
Search Trees
Only Non-Challenge
Chemistry tests returned
System Hierarchy
Component Hierarchy
Click on details for more
information about the
selection
Export according to
Configuration
Extremely fast
Include and exclude criteria
Partial string matching (using wildcards)
Vreeman DJ, Finnell JT, Overhage JM. A Rationale for Parsimonious Laboratory Term
Mapping by Frequency. AMIA Annu Symp Proc. 2007;:771-775.
2014 Regenstrief Institute and James Case
Common in Microbiology
2014 Regenstrief Institute and James Case
Excel Export
Export Terms to
Delimited File
Select Delimiter
Other RELMA
Features
2014 Regenstrief Institute and James Case
Double-click
panel test to see
components
Clinical Panels
35089-2, 35090-0
HIPAA Attachments
Select Propose a
new LOINC
Required fields in
red
Navigate through
proposed terms
301-555-1314
NIH/NLM
301-555-1315
James.case@mail.nih.gov
X
X
X
Choose whether to
send or postpone
Direct submission
via web
All required
components filled in
The code is
from LOINC
The code is
from SNOMED
OBX-5: Data
A code for L.
monocytogenes
Q and A Session
Exercise
Map your own data