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. 
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.
Comments:
| 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.