Beruflich Dokumente
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RELMA
OrIn
Search
of
the
Missing
LOINC
Clinical
LOINC
Meeting
August
2015
Acknowledgements
LOINC
Development
Team
Clem
McDonald,
Dan
Vreeman,
Jami
Deckard,
David
Baorto,
Rachel
Fuhr,
Katy
Holck,
Swapna
Abhyankar
Overview
of
LOINC
Reviewing
new
RELMA
features!
Installing
RELMA
SeMng
personal
preferences
Loading
a
Local
ObservaHon
File
(LMOF)
Searching
for
a
LOINC
Term
Preparing
LMOF
for
Mapping
Review
of
Map
Screen
FuncHons
SeMng
Search
Limits
Mapping
Local
Terms
to
LOINC
Viewing
LOINC
Term
Details
Proposing/SubmiMng
New
LOINC
Terms
ExporHng/PrinHng
Mapped
Terms
Mapping
Special
SituaHons
Mapping
your
own
LMOF
data
2014 Regenstrief Institute
Levels
of
Interoperability
Basic
allows
data
to
be
exchanged
between
computer
systems
Comparability
Meaning
of
the
data
is
consistent
when
shared
among
dierent
parHes
Detailed
General
General
Detailed
2014 Regenstrief Institute
The
Problem
In
a`empHng
to
arrive
at
the
truth,
I
have
applied
everywhere
for
informaHon,
but
in
scarcely
an
instance
have
I
been
able
to
obtain
hospital
records
t
for
any
purpose
of
comparison.
If
they
could
be
obtained,
they
would
enable
us
to
decide
many
other
quesHons
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
suciently
widely
known
for
communicaHon
with
the
outside
world.
U.
Forsum
et
al.,
Pure
Appl.
Chem
72:555-745,
2000
Proper3es
and
Units
in
the
Clinical
Laboratory
Sciences
Part
VII.
Proper3es
and
Units
in
Clinical
Microbiology
2014 Regenstrief Institute
LOINC
101
Emphasis
on
Laboratory
LOINC
5193-8
HepaCCs
B
virus
surface
Ab
ACnc
Component
Property
Measured
Pt
Timing
Ser
System
Qn
Scale
EIA
Method
TesHng
instrument
Specic
details
about
the
specimen
Priority
(e.g.
STAT)
Where
tesHng
was
done
Who
did
the
test
Test
interpretaHon
Pricing
or
cost
Anything
not
part
of
naming
the
test
Things
from
other
elds
in
an
HL7
arHfact
2014 Regenstrief Institute
Component/Analyte
The
substance
or
enHty
that
is
measured,
evaluated,
or
observed
-
Sodium
-
Glucose
-
Brucella
sp.
organism
-
Inuenza
A
Virus
anHgen
- Cytomegalovirus
Virus
anHbody
- Lipids.Total
5193-8:Hepatitis
B
virus
surface
Ab:ACnc:Pt:Ser:Qn:EIA
2014 Regenstrief Institute
Component Structure
Analyte Name^Challenge^Adjustments
Formal analyte name
Calcium
Specify subanalytes
May have subclasses
Coronavirus Ag
Calcium.ionized
Challenge
Two parts separated
by post
Adjusted to pH 7.4
Adjustments
2014 Regenstrief Institute
Property
the
most
dicult
LOINC
axis
Property
the
most
dicult
LOINC
axis
RaCo
=
mulHple
analytes
from
same
system
MCrto:
BUN/CreaHnine
in
serum
RelaCve
RaCo
=
measures
from
dierent
system
RelRto:
Albumin.pericard
d/Albumin.SerPl
2014 Regenstrief Institute
PR vs PRID
Timing*
The
interval
of
Hme
over
which
the
observaHon
or
measurement
was
made
Pt
-
at
a
point
in
Hme
12H
-
a
twelve
hour
collecHon
24H
-
a
twenty
four
hour
collecHon
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
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
Scale
(Special)
OrdQn
Ordinal
or
QuanHtaHve
Method
Only
needed
if
interpretaHon
aected
AggluHnaHon
Enzyme
Immunoassay
Probe
with
target
amplicaHon
5193-8:Hepatitis
B2014
virus
surface
Ab:ACnc:Pt:Ser:Qn:EIA
Regenstrief Institute
Hierarchies
LOINC
Class
one
per
term
arbitrarily
assigned
What
is
in
LOINC?
Content
Term
structures
Submi`ed
units,
Example
UCUM
units
Synonyms
Answer
lists
(increasing
number)
Text
descripHons
links
to
info
sources
about
individual
tests
Panel
structures
Foreign
language
translaHons
RELMA
Purpose
of
Tutorial
Eliminate
need
to
read
the
Users
Manual
Become
familiar
with
RELMA
features
Provide
some
insight
into
mapping
Hps/piyalls
Help
begin
the
mapping
process
for
your
insHtuHon
Hang
with
some
really
cool
folks
RELMA
Functions
LOINC
les
and
indexes
Manual
and
automated
mapping
funcHons
RELMA
tools
transform
local
words
in
local
le
2014 Regenstrief Institute
RELMA
Highlights
Browse-able
hierarchies
of
LOINC
parts
Display
search
results
in
tree
view
Enhanced
details
view
of
terms/parts
References
DescripHons
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 les
Running RELMA
Version 6.7
Copyright Screen
LOINC crowdsourcing
All Spanish!
File
Locations:
(See
prior
slide
for
location)
Startup
Screen
Preference
Importing
Local
Terms
into
RELMA
Ba`ery/Panel
Code
Ba`ery/Panel
DescripHon
or
Name
*Local
Code
*Test
DescripHon
or
Name
Units
Example
Values
Laboratory
SecHon
Local
Code
Local
DescripHon
Units
(highly
recommended)
2014 Regenstrief Institute
Manual
Enter/Edit
View/Add/Edit
Local
Terms
Edit\Add\Delete
Terms
Export
Terms
User
assigned
tags
Text
alignment
option
BUBPLAG
BUBONIC PLAGUE RRT PCR
Add
tags
Click
to
Add
to
Current
Working
File
Import Button
Fields Segregated
Ready
to
Import
Minimum
assignments
Tag terms
New
gield
assignment
Imported tags
OBR
ID
OBR
descripHon
OBX
ID
OBX
descripHon
Sample
of
results
with
Real
values
Units
Abnormal
ags
Normal
ranges
2014 Regenstrief Institute
Skip
import
of
sample
values
Name
the
Local
Term
File
(working
set)
Import_Sample_OBR.txt
Sample_HL7.HL7
Assign
Replacement
LMOF
AOptions
ttribute
Term Substitution
Comprehensive
Search
Only
Tool
Search
Window
Help
File
Enter
Search
Terms
Limit
to
Specigic
Units
Use
different
logic
Restrict Limits
Search Window
Clinical
Automapper
rank
No Limits selected
Context Menu
Keyword
ComponentWordCount
restricts
word
count
Restricting
to
Component
Axis
regines
further
Large
number
of
results
Answerlist details
Welcome
Screen
Select
the
subset
of
terms
to
work
with:
All
Mapped
Unmapped
Set
your
Search Limits
Bu`on
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
Congigure
Grid
Select
elements
to
display
Reorder
grid
elements
Begin
a
search
(or
hit
enter)
EEK!
Whatll
I
do?!
Click
to
show
words
used
in
search
2014 Regenstrief Institute
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
(or doubleclick)
If
comments
option
is
selected,
prompt
appears
LOINC
Term
Assigned
Panel Children
Output
Options
Include
column
headers
Save
Congiguration
and/or
Export
Panel
Name
Parent
LOINC
code
Conditionality
Panel Children
Class
LOINC
code
LOINC code
AnswerListID
Answer String
More
on
Searching
Search
Screen
Example
DeniCon
Inuenza virus A
AND
Morphine
AND
Opiates
OR
Inuenza
OR
Parainuenza
NOT
Gluc?se
(glucose,glucase)
Gluc*se
(glucose,
glucuronidase,
etc.)
Search Qualigiers
Exclude Glucosidase
DescripCon
( )
Fieldname:
Fieldname:()
{}, []
129 terms
6 terms
Limiting Searches
Toggle Buttons
Search
Constraints
Attribute
trees
Expanded
predegined,
general
search
constraints
Specimen
constraints
Exclude laterality
Exclude laterality
Laterality terms
Restrict
to
common
orders
Common
orders
rank
Large
number
of
candidates
Methodless
Terms
Restriction
Only
Methodless
Terms
Appear
Order/Observation Restriction
Order
or
Observation
preference
2014 Regenstrief Institute
Three
top-level
branches
Tree
Navigation
Buttons
Large
number
of
candidate
terms
2014 Regenstrief Institute
Search Trees
Selecting
subclass
constrains
search
to
all
members
System Hierarchy
Component
Hierarchy
Click
on
details
for
more
information
about
the
selection
Export
according
to
Congiguration
Extremely
fast
Include
and
exclude
criteria
ParHal
string
matching
(using
wildcards)
Special Situations
Nursing
Assessments
Radiology
content
Document
Ontology
Validated
Instruments
Radiology
Modality
Everything
Else
Anatomic
Region
2014 Regenstrief Institute
Document
Ontology
Be
aware
of
the
Document
Ontology
model
Setting
Kind
of
Document
Subject
Matter
domain
2014 Regenstrief Institute
Physiologic
Assessments
Basic
Med/Surg
Assessment
Submi`ed
Assessment
Framework
New
Nursing
Judgment
(Impression)
LOINC
codes
Future
Nursing
LOINC
Landing
Page
2014 Regenstrief Institute
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
Excel Export
Export
Terms
to
Delimited
File
Select Delimiter
Other
RELMA
Features
2014 Regenstrief Institute
Laboratory Panels
Expand
category
to
see
panels
Double-click
panel
test
to
see
components
Government Panels
Panel Codes
Form Category
Clinical Panels
35089-2, 35090-0
HIPAA Attachments
Select
Propose
a
new
LOINC
Required
gields
in
red
Navigate
through
proposed
terms
801-447-9294
3M HIS
801-447-9294
smatney@mmm.com
X
X
X
Choose
whether
to
send
or
postpone
Direct
submission
via
web
All
required
components
gilled
in
The
code
is
from
LOINC
The
code
is
from
SNOMED
OBX-5:
Data
A
c
ode
for
L.
monocytogenes
Q and A Session
Exercise
Map
your
own
data