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Boosting LOINC® completion within a Medical Laboratory File

  • Tuesday, 25 January 2022 13:13
  • Written by 

Our experience with LOINC mapping has guided us to expect 75-85% identification of existing LOINCs for a test catalog, and we set customer expectations accordingly. There’s usually a small percentage of entries that would not be suitable for a LOINC term. These included internal tracking – department record keeping which the lab finds helpful to document in the laboratory information system (LIS) while running patient assays. Examples are billing information, diagnosis, comments, exclusion criteria, instrument maintenance checks and more. This subset won’t be direct measurements but different categories of textual information that interpret, comment or support the direct measurements in chemistry, serology, molecular, genetics and the like. Regenstrief Institute in recent years has been tackling textual result fields and created terms to cover some of these areas – see recent Tip When to use LOINC® specialist reviews for background. 
Here’s a demonstration. TesttubeReport400

The data extract from the LIS into a flat file for mapping to LOINC will include the Order mnemonic/display with detailed information about the Result mnemonic/display (units of measure, specimen, result type, example answers). This allows the evaluation of each Result mnemonic’s usage by sorting the file by Result mnemonic and seeing all the Order panels where it’s included.

The data field label may contain source of origin (gene study, serology marker, or assay name) along with the keywords of “comments” or “interpretation”. This is crucial in identifying the department specialist role reviews that should be applied.

Examples include:

Local Display LOINC LOINC Attributes
ALK FISH Comments 69047-9 Geneticist review:Imp:Pt:XXX:Nar:
anti-GAD Interpretation 69048-7 Immunologist review:Imp:Pt:XXX:Nar:
anti-RyR Interpretation 69048-7 Immunologist review:Imp:Pt:XXX:Nar:
Beta Globin Cluster Locus Del/Dup Interp 69047-9 Geneticist review:Imp:Pt:XXX:Nar:
CD10 Comments 69052-9 Flow cytometry specialist review:Imp:Pt:XXX:Nar:
C-MET IHC Comments 59465-5 Pathologist review:Imp:Pt:XXX:Nar:
dRVVT Mix Interpretation 69049-5 Coagulation specialist review:Imp:Pt:XXX:Nar:
Additional Elution Info 19066-0 Blood bank comment:Imp:Pt:^Patient:Nom:
Additional Elution Info 2 19066-0 Blood bank comment:Imp:Pt:^Patient:Nom:
Additional Elution Info 3 19066-0 Blood bank comment:Imp:Pt:^Patient:Nom:

Comment fields would need to be unique as supportive information for a particular assay in order to leverage the role/department specific reviews.

If a comment data element is used throughout laboratory disciplines, use the following – note that two or more examples are provided for each LOINC term.


Local Display LOINC LOINC Attributes
COMMENTS 8251-1 Service comment:Imp:Pt:XXX:Nom:
Slides Used Comment 8251-1 Service comment:Imp:Pt:XXX:Nom:

Narrative reviews:

Local Display LOINC LOINC Attributes
Additional Information 48767-8 Annotation comment:Imp:Pt:{system}:Nar:
Tumor Annotated 48767-8 Annotation comment:Imp:Pt:{system}:Nar:

Supportive information about the assay process:

Local Display LOINC LOINC Attributes
# blocks used C-MET result 94330-8 Processing comment:Find:Pt:Specimen:Nom:
# CD138- Aliquots 94330-8 Processing comment:Find:Pt:Specimen:Nom:
# Cells Counted Post Thaw 94330-8 Processing comment:Find:Pt:Specimen:Nom:
# of Additional Slides Requested 94330-8 Processing comment:Find:Pt:Specimen:Nom:


Here are some statistics showing the measurable gains accomplished using these mapping tactics:

Site Absolute # result fields Absolute # comments/reviews % increase
1 2763 71 2.5%
2 1310 28 2.1%
3 14513 1479 10.1%
4 3399 153 4.5%


If the team can help your terminology adoption projects for laboratory, pharmacy, radiology or other clinical projects, contact us.