20 jahre loinc - etouches · titr pt csf qn la titer thyroperoxidase ab [titer] in cerebral spinal...
TRANSCRIPT
20 Jahre LOINC
Hat es eine Zukunft als semantisches
Codiersystem von Laboranalysen?
Auch in der Schweiz?
W.Fierz
Das semiotische Dreieck
Ding, Begriff und Symbol sollen eindeutig zusammengehören 20. Sept. 2011 3
Das semiotische Dreieck im Labor
Ding, Begriff und Symbol sollen eindeutig zusammengehören
eindeutiger
LOINC Code
Antikörper
gegen TPO
Methode
Material
Einheiten
Konzentration
Labor-spezifische
Auslegung
(Messung)
Medizinische Ontologien,
Terminologien, Vokabulare
• UMLS: Unified Medical Language System (NLM)
• MeSH Thesaurus: Medical Subject Headings (NLM)
• Galen: Generalized Architecture for Languages, Encyclopaedias and Nomenclatures in Medicine
• LOINC: Logical Observation Identifiers Names and Codes
• SNOMED CT: Systematized Nomenclature of Medicine Clinical Terms
• DRG, ICD-10, READ: Klassifizierungssysteme
20. Sept. 2011 W. Fierz, lmz Dr Risch 5
www.loinc.org
Labor-Codes: 6 Dimensionen
1. Komponente (Analyt)
2. Eigenschaft / Einheiten (Masse, Aktivität, etc.)
3. Zeit (Zeitpunkt, Intervall)
4. System (Probenmaterial)
5. Skala (quantitativ, qualitativ, etc.)
6. Methode
• Synonyme (Abkürzungen, etc.)
Logical Observation Identifiers Names and Codes (LOINC®)
HL7 LOINC Dokumenten-Typen zB: 11502-2 LABORATORY REPORT.TOTAL
Sept. 2015 W. Fierz, lmz Dr Risch 6
LOINC-Codes für TPO-Antikörper
LOINC
# Component Property
Time
Aspect System Scale Method Ex. Units Long Common Name
14296-8 Thyroperoxidase
Ab SCnc Pt Ser/Plas Qn Thyroperoxidase Ab [Moles/volume] in Serum or Plasma
17706-3 Thyroperoxidase
Ab Titr Pt CSF Qn LA titer
Thyroperoxidase Ab [Titer] in Cerebral spinal fluid by Latex
agglutination
17707-1 Thyroperoxidase
Ab.IgM ACnc Pt Ser/Plas Qn
Thyroperoxidase IgM Ab [Units/volume] in Serum or
Plasma
18332-7 Thyroperoxidase
Ab.IgG ACnc Pt Ser/Plas Qn
Thyroperoxidase IgG Ab [Units/volume] in Serum or
Plasma
32042-4 Thyroperoxidase
Ab ACnc Pt Ser/Plas Ord Thyroperoxidase Ab [Presence] in Serum or Plasma
32786-6 Thyroperoxidase
Ab Titr Pt Ser/Plas Qn titer Thyroperoxidase Ab [Titer] in Serum or Plasma
5382-7 Thyroperoxidase
Ab ACnc Pt Ser/Plas Qn RIA
Thyroperoxidase Ab [Units/volume] in Serum or Plasma by
Radioimmunoassay (RIA)
5383-5 Thyroperoxidase
Ab Titr Pt Ser/Plas Qn LA titer
Thyroperoxidase Ab [Titer] in Serum or Plasma by Latex
agglutination
56477-3 Thyroperoxidase
Ab ACnc Pt Ser/Plas Qn EIA index
Thyroperoxidase Ab [Units/volume] in Serum or Plasma by
Immunoassay
8099-4 Thyroperoxidase
Ab ACnc Pt Ser/Plas Qn
IU/mL;unit
s/mL Thyroperoxidase Ab [Units/volume] in Serum or Plasma
Sept. 2015 W. Fierz, lmz Dr Risch 7
LOINC-Codes für TPO-Antikörper
Sept. 2015 W. Fierz, lmz Dr Risch 8
LOINC Codes
20. Sept. 2011 W. Fierz, lmz Dr Risch 9
Laboratory Technical Framework
Vol. 4: LOINC Test Codes Subset
Quelle: www.ihe.net/Technical_Framework/upload/ihe_lab_tf_rel2-4.pdf
Sept. 2015 W. Fierz, lmz Dr Risch 10
Probleme?: Beispiel Vitamin D3
Code Component Vitamin Property Time System Scale Method Units
35365-6 Vitamin D+Metabolites D3+D2 MCnc Pt Ser/Plas Qn ng/mL
49543-2 Calcidiol+Calciferol D3+D2 MCnc Pt Ser/Plas Qn ng/mL
1989-3 Calcidiol D3 MCnc Pt Ser/Plas Qn ng/mL
1990-1 Cholecalciferol D3 MCnc Pt Ser/Plas Qn
49054-0 25-Hydroxycalciferol D3 MCnc Pt Ser/Plas Qn ng/mL
47094-8 Calciferol D2 SCnc Pt Ser/Plas Qn pmol/L
Sept. 2015 W. Fierz, lmz Dr Risch 11
Redundanzen
Common Lab Orders LOINC Value Set
Version 1.1 (April 7, 2010)
1) The Indiana Health Information Exchange (INPC), who reported ordering
statistics from a sample of 10 million orders from more than 15 hospitals
and clinics.
2) Health Care (UHC) who derived their statistics from a sample of 30 million
referral laboratory test results from their nationwide database.
3) Five Northeast US hospitals that derived their statistics from a sample of 1.5
million orders.
4) One Southeast US hospital that derived its statistics from 200,000 test
orders.
5) A list of about 200 tests gathered by survey from an internal medicine
project run by Stasia Kahn, MD (Chicago).
Sept. 2015 W. Fierz, lmz Dr Risch 12
Common Lab Orders LOINC Value Set
Version 1.1 (April 7, 2010)
• Value set of universal laboratory order codes from LOINC includes 292
laboratory test and test panel codes
• The purpose of this value set is to define a set of universal laboratory order
codes that would be recommended and adopted by developers of order
entry systems for delivery in HL7 messages to laboratories, where they
could be understood and fulfilled.
• This value set is designed to cover greater than 95% of the test ordering
volume in the US, and was developed with both empirical and consensus-
driven approaches.
• This list … "should be considered a minimum 'starter' set" and "does not
attempt to include all possible LOINC codes" or all possible lab orders.
Quelle: loinc.org/usage
Sept. 2015 W. Fierz, lmz Dr Risch 13
Erfahrungen aus den USA
Methods Inf Med 2011; 50: 105–114 Sept. 2015 14
medical informatics project
initiated in 1997 in Geneva
Einführung in der Schweiz ? Einführung
in Einführung in der Schweiz ?
Einführung in der Schweiz ?
• Empfehlung durch die Expertengruppe Semantik von
eHealth Suisse ? -> Anwendungsfälle www.e-health-suisse.ch/umsetzung/00146/00148/00244/index.html
• Über die eidg. Analysenliste:
– in Arbeit seit August 2015, unterstützt durch
eHealthSuisse
– erste 200 Positionen sind codiert.
• Durch die Industrie: Kennzeichnung der Analysen-Kits ? ivdconnectivity.org/
Semantik im Laborumfeld /
LOINC-Anwendungsfälle
eHealth Suisse
„Semantik und Metadaten“
IHE/HL7/LSI/SULM
Projektgruppe Labor
HL7 CH IHE Suisse FAMH SULM
BAG
Strategie
Umsetzung
Use cases Value Set für
Meldungen von
Erregernachweisen
CDA-CH-LRPH
Sektion
Meldesysteme
Sektion
Transplantation und
Fortpflanzunungsmedizin
Value Set für
Laborbefunde im
Transplantationsprozess
CDA-CH-LRTP
User
QUALAB
Q-Control
Centers
Value Set für
Laborbefunde
Ringversuchen
CDA-CH-LRQC
18
IVD Industry Connectivity Consortium (IICC)
ivdconnectivity.org
IICC
Board of Directors
Executive Committee
Jay Jones, PhD, Director of Chemistry and Regional Labs Geisinger Health Systems
X
Provider Review Committee Chair
Mojgan Lefebvre, Corporate Vice President & CIO bioMérieux
X
President
Jean-Claude Lugeon, Head of Methods and IT Architecture Roche Diagnostics
X
Carl Murray, Principal Staff Software Development Engineer Beckman Coulter
X
Eric Olson, Vice President of Informatics and eBusiness Siemens Healthcare Diagnostics
X
Chief Technology Officer
Scott Goss, Global Marketing Director Informatics & New Instrument System Development Abbott Diagnostics
Treasurer & Secretary
Sept. 2015 W. Fierz, lmz Dr Risch 19
IICC and LOINC Rob Bush, Orchard Software
LOINC Planning Memo 7 June 2011
INTRODUCTION TO PROJECT
Dr. Fierz, a lab director in Switzerland, has made a very practical suggestion in a letter to
Eric Olsen. He asked that the IICC promote the inclusion of LOINC code information
on test kit labels or in the package inserts for assays.
…
While Eric points out that labeling is outside the scope of our interface standards group
(IICC), it is within our scope to consider the problem of test identification within our
interfaces, and subsequently within our databases. ...
…
I believe there is a very valuable side task that our IICC could accomplish on his behalf.
…
Sept. 2015 W. Fierz, lmz Dr Risch 20
IICC and LOINC
Key to our success will be identifying people from each of our member companies who
will commit to accomplishing this task within our chosen time frame (which I
recommend is by Aug 2011).
…
To help with this task, I propose that Orchard write a small database tool that will help us
consolidate information and compare our work. …
…
As a way to disseminate this information, I propose that we post the results on the IICC
site (IVDconnectivity.org) and on the Regenstrief site (regenstrief.org).
…
Unquestionably, each company will want to be able to provide this information to their
own clients. As we complete the project we can further discuss how we can facilitate
this goal.
Rob Bush
Orchard Software
Sept. 2015 W. Fierz, lmz Dr Risch 21
Beckman Coulter
IICC Conducts Live Plug and Play Instrument
Connectivity Demonstrations at AACC 2015
• At its booth at AACC 2015, the IVD Industry Connectivity
Consortium (IICC) successfully conducted live plug and play
instrument connectivity demonstrations of the IICC/IHE LAW Profile.
• It involved one analyzer (Abbott) and one analyzer manager
(Orchard Software) in the booth, as well as one remote analyzer
(Beckman) connecting over the Internet to the cloud-based IHE
Gazelle Order Manager simulator.
• In addition to establishing a plug and play connection and
exchanging work orders and test results using the LOINC
vocabulary, the participants also demonstrated several features
defined in the LAW Profile,
LOINC und andere
Nomenklaturen
Nomenclature Properties and Units
(C-NPU)
SNOMED CT
IUPAC/IFCC Commission on
Nomenclature Properties and Units (C-NPU)
International Union of Pure and Applied Chemistry
LOINC, C-NPU & SNOMED CT
LOINC, C-NPU & SNOMED CT
SNOMED CT and LOINC
http://www.ihtsdo.org/loinc/press_release.pdf www.ihtsdo.org/loinc/agreement.pdf
SNOMED CT and LOINC
https://loinc.org/downloads/files/loinc-snomed-ct-expression-associations-technology-preview
2014-10-27
Danke für das Interesse
LOINC !