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A Watched Pot Never Boils?

  • Wednesday, 21 April 2021 12:18
  • Written by 

Have you ever had a project go off track and in trouble? Did any of them happen because of the COVID-19 pandemic? campkettle400

The old adage “a watched pot never boils” may imply that there’s no point paying attention until something happens, but I’m going to put forward the opposite point of view – that you should watch your pots (terminology projects) so they don’t leave your control.

LOINC mapping for the detection of SARS-CoV-2 antigens, antibodies and nucleic acids is a great example of a “pot”, at the moment. Public health departments all the way up to the CDC have been demanding LOINC coded data since February 2020. Not only the positives, give them the negatives too! Laboratories that hadn’t yet adopted LOINC were rushing to figure out what was needed to make it happen.

We’ve previously discussed the activity of the standards development organizations (LOINC and SNOMED CT). In spring of 2020, after the Council of State and Territorial Epidemiologists (CSTE) reported that public health messages were not codified with the standards, the CDC and FDA came together to create and publish a comprehensive list of all manufacturers in receipt of an Emergency Use Authorization (EUA), along with the appropriate LOINC and SNOMED CT terms. Originally created by the In Vitro Diagnostics Industry Connectivity Consortium (IICC), the LOINC in vitro diagnostic (LIVD) template was meant to reside with one manufacturer and include their entire compendium. The current list is found at https://www.cdc.gov/csels/dls/sars-cov-2-livd-codes.html.

There were spurts in standard term development over the last 12 months; the generic LOINCs issued early in the pandemic were joined by more definitive components. Communications have been so rapid during the pandemic, it’s easy to miss a pertinent piece of data. The “pots” of those manufacturers listed in the national list will boil over if they aren’t watching the communications or new releases of the lists. Imagine the dismay if a client is more informed and points out to you the LOINC provided locally is not harmonized with the federally publicly available list! (Granted it’s escalated in pandemic measurements.) It may be tempting for the manufacturers that hadn’t created their local LIVD to have the federal organizations do it for them. But terminology is never a “one and done” project.

Adoption of a terminology standard requires regular review for changes that may impact encoding, particularly to standards. Perhaps a kit now can be performed on an additional specimen; perhaps a new viral target is detected. We always recommend a quick review upon changes in test name, specimens, units of measure, result format and methodology, and to sign up for mailing lists or notifications to help with tracking.

If you have questions or suggestions for future topics of discussion, or need help implementing or mapping to standard terminologies, please contact us.