2014 12 03 - loinc introduction
TRANSCRIPT
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Daniel J. Vreeman, PT, DPT, MScAssociate Research Professor
, Indiana University School of Medicine
Associate Director for Terminology Services, Regenstrief Institute, Inc
© 2014
An Introduction to LOINC
Laboratory LOINC Workshop - Indianapolis, IN USA
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Acknowledgements
LOINC Development TeamJami Deckard, Katy Holk, Swapna Abhyankar,Rachel Fuhr, David Baorto, Clem McDonald
RELMA Development Team
John Hook, Anandhi Sowmyan, James Dennis
Others
LOINC Committee, Theresa Pritchard,
Sandy Poremba
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Overview
1. Origins and purpose of LOINC
2. The LOINC way
3. LOINC today
4. Overview of implementation resources
photo via Vernio77
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Origins of LOINC
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA
. 1998;280(15):1325-1329.
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Informatics Pioneers
40 years of EMR work
Indiana Network for Patient Care
Regenstrief serves as neutral 3rd party
convener
Most comprehensive and longest tenured Health Information Exchange (HIE) in USA
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Informatics Pioneers
40 years of EMR work
Indiana Network for Patient Care
Regenstrief serves as neutral 3rd party
convener
Most comprehensive and longest tenured Health Information Exchange (HIE) in USA
Crash Test Dummies
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Forrey AW, McDonald CJ, et al. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronicreporting of clinical laboratory test results. Clin Chem. 1996 Jan;42(1):81-90. PubMed PMID: 8565239.
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More than Meets the Eye
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Fundamental challenges:
Local systems have different ways of
identifying the same concept.
Things that look alike aren’t the same.
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Forrey AW, McDonald CJ, et al. Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronicreporting of clinical laboratory test results. Clin Chem. 1996 Jan;42(1):81-90. PubMed PMID: 8565239.
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Logical
Observation
IdentifiersNames and
CodesA universal code system that facilitates exchange,
pooling, and processing of clinical data.
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Established in 1994 byRegenstrief Institute.
Vocabulary standard for
observation identifiers.
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LOINC is like a bar code for
test data…
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photo via puuikibeach
WE DOMEASUREMENTS
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Laboratory LOINC
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Top 10 Lab Domain Overview
Microbiology 10,700
Chemistry 9,200
Drug/Toxicology 7,200
Allergy 3,900Chemistry - Challenge 3,700
Serology 2,500
Hematology 2,100Antibiotic Susceptibilities 1,700
Cell Markers 1,500
Molecular Pathology900
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Clinical LOINC
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If an observation is a question
and the observation value isan answer…
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LOINC provides codes for questions
Where needed, other vocabularies
provide codes for answers
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What is my patient’shemoglobin level?718-7:Hemoglobin:MCnc:Pt:Bld:Qn
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How fast does mypatient usually walk?41959-8:Walking speed:Vel:1W^mean:^Patient:Qn:Calculated
photo via Ed Yourdon
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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MSH|^~\&|HOSPITAL_A|SAMPLE_HOSPITAL_A|||$YearMonthDay||||||||||||||| PID|||$patientId$||$patientName$|||||||||||||||||||| PV1|||||||$attendingDoctor$||$consultingDoctor$||||||||
OBR|1|||012^CBC/Auto Diff^HSPA^57021-8^CBC W Auto Diff^LN||$reqDate||||||||| OBX|2|NM|123^WBC^HSP_A^26464-8^Leukocytes [#/volume] in Blood^LN||10.8|K/MM3|||||F| OBX|3|NM|234^RBC^HSP_A^26453-1^Erythrocytes [#/volume] in Blood^LN||4.82|MIL/MM3|||||F| OBX|4|NM|345^HGB^HSP_A^718-7^Hemoglobin [Mass/volume] in Blood^LN||15.7|GM/DL|||||F| OBX|5|NM|456^HCT^HSP_A^20570-8^Hematocrit [Volume Fraction] of Blood^LN||45|%|||||||F|
LocalCode^LocalName^CodeSystem^LOINCcode^LOINCname^CodeSystem
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Codes for individual observations
Leukocytes [#/volume] in Blood by Automated countErythrocytes [#/volume] in Blood by Automated count
Hematocrit [Volume Fraction] of Blood by Automated count
and collections of observations
CBC W Auto Differential panel - Blood
Vital signs, weight and height panel
PHQ-9 quick depression assessment panel
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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT
Result with a Coded Value
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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT
Result with a Coded Value
Data type of result
(OBX-5) is a coded
element
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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT
Result with a Coded Value
This code is from
LOINC
Code identifying this
observation
(what are these results?
Bacteria identified by
Blood Culture )
Data type of result
(OBX-5) is a coded
element
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OBX||CE|600-7^Bacteria Bld Cult^LN||56415008^Klebsiella pneumoniae^SCT
Result with a Coded Value
This code is from
LOINC
Code identifying this
observation
(what are these results?
Bacteria identified by
Blood Culture )
Data type of result
(OBX-5) is a coded
element
This code is from
SNOMED
Code identifying the result
(K. pneumoniae)
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LOINC fits well withother data standards
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The LOINC WayOpen. Nimble. Pragmatic.
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Development Approach
Worldwide distribution at no cost
New terms requested by end-users
Welcome all comers Committees are volunteers
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Development Approach
Worldwide distribution at no cost
New terms requested by end-users
Welcome all comers Committees are volunteers
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Development Approach
Worldwide distribution at no cost
New terms requested by end-users
Welcome all comers Committees are volunteers
It’s free, but invaluable
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Financial Support
Many sourcesAHCPR, ASPE, CDC, CHCF, CMS, Hartford Foundation, IN
CTSA, Regenstrief Foundation*, Regenstrief Institute,
NCRR, NIBIB*, NLM*, LOINC User Community**active now
Today, the U.S. National Library of Medicine
(NLM) accounts for about 2/3 of our funding.
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Major releases
twice per year
(June and December)
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LOINC C d O Ti b R l
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1
2
3
4
5
6
7
8
4 / 2 4
/ 1 9 9
5 | 1 . 0
5
/ 2 4 /
1 9 9 5
| 1 . 0 a
6
/ 2 3 /
1 9 9 5
| 1 . 0 b
6
/ 2 8 /
1 9 9 5
| 1 . 0 c
7
/ 1 4 /
1 9 9 5
| 1 . 0 d
9
/ 1 5 /
1 9 9 5
| 1 . 0 e
1 2 /
2 1 / 1
9 9 5 | 1 . 0 f
4
/ 2 8 /
1 9 9 6
| 1 . 0 g
8 / 2 9 /
1 9 9 6
| 1 . 0 h ( 2 )
1 2 / 3 /
1 9 9 6
| 1 . 0 h ( 3 )
1 / 8 /
1 9 9 9
7 | 1 . 0 i
1 0
/ 9 / 1
9 9 7 | 1 . 0 j
- a
5 / 1 /
1 9 9 8
| 1 . 0 k
2 / 1 2
/ 1 9 9
9 | 1 . 0 l
7 / 2
3 / 1 9
9 9 | 1 . 0 m
8 / 6
/ 1 9 9
9 | 1 . 0 m a
2 / 4 /
2 0 0 0
| 1 . 0 n
6
/ 1 3 /
2 0 0 0
| 1 . 0 0
1 / 1 /
2 0 0 1
| 2 . 0 0
1
/ 3 1 /
2 0 0 1
| 2 . 0 1
7 / 1 /
2 0 0 1
| 2 . 0 3
1 / 1 /
2 0 0 2
| 2 . 0 4
2 / 1 /
2 0 0 2
| 2 . 0 5
2
/ 1 9 /
2 0 0 2
| 2 . 0 6
8 / 1 /
2 0 0 2
| 2 . 0 7
9 / 1 /
2 0 0 2
| 2 . 0 8
5 / 1 /
2 0 0 3
| 2 . 0 9
1
0 / 1 /
2 0 0 3
| 2 . 1 0
1 / 1 /
2 0 0 4
| 2 . 1 1
2 / 1 /
2 0 0 4
| 2 . 1 2
1
2 / 1 /
2 0 0 4
| 2 . 1 3
1
2 / 1 /
2 0 0 4
| 2 . 1 4
6 / 1 /
2 0 0 5
| 2 . 1 5
1
2 / 1 /
2 0 0 5
| 2 . 1 6
6 / 1 /
2 0 0 6
| 2 . 1 7
1 2 /
2 1 / 2
0 0 6 | 2 . 1 9
6 / 2 1
/ 2 0 0
7 | 2 . 2 1
1 2 /
0 3 / 2
0 0 7 | 2 . 2 2
7 / 1 0
/ 2 0 0
8 | 2 . 2 4
1 / 1 0
/ 2 0 0
9 | 2 . 2 6
0 7 /
0 6 / 2
0 0 9 | 2 . 2 7
1 2 /
3 0 / 2
0 0 9 | 2 . 2 9
2 / 2 6
/ 2 0 1
0 | 2 . 3 0
6 / 1 5
/ 2 0 1
0 | 2 . 3 2
1 2 /
2 9 / 2
0 1 0 | 2 . 3 4
0 6 /
3 0 / 2
0 1 1 | 2 . 3 6
1 2 /
3 0 / 2
0 1 1 | 2 . 3 8
6 / 3 0
/ 2 0 1
2 | 2 . 4 0
1 2 /
3 0 / 2
0 1 2 | 2 . 4
2
0 6 /
2 9 / 2
0 1 3 | 2 . 4
4
1 2 /
2 6 / 2
0 1 3 | 2 . 4
6
0 6 /
2 6 / 2
0 1 4 | 2 . 4
8
LOINC Codes
Only Lab LOINC Codes
LOINC Codes Over Time by Release
laboratory terms only
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73,000 codes…haven’tyou finished yet?
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Lots Cooking…Always more lab tests
Genetic testing
Patient reported outcomes
Translational research data
Document titles
Radiology reportsphoto via liber
photo via liber
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Legal Stuffhttp://loinc.org/terms-of-use
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Just kidding.
Copyright is a good thing for
standards.
It’s the licensing part that issometimes interesting.
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No cost
Worldwide
In perpetuity
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Use
Copy
Distribute
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Any purpose:
commercial
non-commercial
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Encourages
translation into
other languages
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CANNOT use anyLicensed Material to
develop or promulgatea different standard for
orders or observations.
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That would defeat
the purpose of
having a standard!
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Does LOINC have anycompetitors?
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And if it should cross yourmind to develop yet another
biomedical vocabulary,please DON'T do it.
~ Betsy Humphreys, Morris Collen Award Acceptance Speech
“
photo via wikipedia
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Only crazy people buildterminologies
photo via Tatiana Gerus
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Collaboration Trumps Competition
We're committed to working together with
other standards development
organizations to help health data moveseamlessly when and where it's needed.
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LOINC in action today
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photo via iboy_daniel
Data standards are like telephones.
They require a critical mass of usersbefore they become useful.
~ Clem McDonald, MD (1998)
“
35,500+ registered users in 163 countries
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35,500 registered users in 163 countries
loinc.org registered users
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0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
6 / 1 / 0 8
1 2 / 1 / 0 8
6 / 1 / 0 9
1 2 / 1 / 0 9
6 / 1 / 1 0
1 2 / 1 / 1 0
6 / 1 / 1 1
1 2 / 1 / 1 1
6 / 1 / 1 2
1 2 / 1 / 1 2
6 / 1 / 1 3
1 2 / 1 / 1 3
6 / 1 / 1 4
1 2 / 1 / 1 4
g g
loinc.org registered users
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0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
6 / 1 / 0 8
1 2 / 1 / 0 8
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1 2 / 1 / 0 9
6 / 1 / 1 0
1 2 / 1 / 1 0
6 / 1 / 1 1
1 2 / 1 / 1 1
6 / 1 / 1 2
1 2 / 1 / 1 2
6 / 1 / 1 3
1 2 / 1 / 1 3
6 / 1 / 1 4
1 2 / 1 / 1 4
g g
8,000 new users per year
loinc.org registered users
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0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
6 / 1 / 0 8
1 2 / 1 / 0 8
6 / 1 / 0 9
1 2 / 1 / 0 9
6 / 1 / 1 0
1 2 / 1 / 1 0
6 / 1 / 1 1
1 2 / 1 / 1 1
6 / 1 / 1 2
1 2 / 1 / 1 2
6 / 1 / 1 3
1 2 / 1 / 1 3
6 / 1 / 1 4
1 2 / 1 / 1 4
g g
8,000 new users per year
Doubled in 2 years
LOINC Translators
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22 organizations.
Currently translations into 18 variants of 12 languages
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Vreeman DJ, Chiaravalloti MT, Hook J, McDonald CJ. Enabling international adoption of LOINC through translation. J Biomed Inform.2012 Aug;45(4):667-73. PMID: 22285984.
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Ad t d N ti l St d d
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Australia
Austria
Belgium
Brazil
Canada
Cyprus
Estonia
Finland
FranceGermany
Iceland
India
Mexico
Mongolia
The Netherlands
New Zealand
Philippines
Portugal
Rwanda
Slovakia
Slovenia
SpainThailand
Turkey
United States
Adopted as National Standard
L I l t ti
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Large Implementations
SIGA Saúde project7+ Provincial systems in Canada
8+ Regional Health Information Exchanges in Spain
ePSOSAssistance publique - Hôpitaux de Paris
Hong Kong Hospital Authority
Philippine Health Insurance CorporationInFSE Project in 5 regions in Italy (LOINC Italia)
M y
Oth K Ad ti
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Other Key Adoptions
Many “big” labsAll health-related federal agencies in USA
Lots of care organizations
Professional societiesHealth information exchange networks
Insurance companies
EHR vendorsInstrument manufacturers (nascent)
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For the last few years, the AP-HP has
been using the LOINC internationalnomenclature…
Thanks to this catalogue, the AP-HPis able to use the nomenclature in itstreatment processes, whenever
biology analyses and test results arerequested.
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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.
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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.
The results of our workvalidate the choice made to
develop a local dictionaryaligned with LOINC.
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Vandenbussche PY, Cormont S, André C, et al. Implementation and management of a biomedical observation dictionary in a large healthcare information system.J Am Med Inform Assoc. 2013 May 1. PMID: 23635601.
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Members of the Korean National StandardsCommittee have enthusiastically embraced LOINC
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LOINCing in Hong Kong
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Some ad hoc LOINCing
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Talking about LOINC at the Thai Ministry of
Information and Comm nication Technology
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Dr Case leading some LOINCing in Cypr s
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In USA, major driver ofeHealth standards adoption is
EHR Incentive Program
a.k.a. “Meaningful Use”
Blumenthal D, Tavenner M. The "meaningful use" regulation for electronic health records. N Engl J Med. 2010 Aug 5;363(6) :501-4. Epub 2010 Jul 13. PubMed PMID: 20647183.
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Stage 12011-2012
Data capture
and sharing
Stage 22014
Advance clinical
processes
Stage 32016
Improved care
outcomes
progressive requirements for data standards
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LOINC adopted for:
1. View, download, transmit data to third party
2.Cancer case reporting to state registry
3.Send/receive electronic lab results inambulatory settings
4.Provide a care summary at care transition
5.Provide clinical summaries for patients 6.Submit reportable lab results to public health
Lab reporting to EHRs
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Use in Quality Measures
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LOINC Adopted For
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LOINC Adopted ForPatient Characteristics
[Non-lab] Diagnostics studies
Patient experience
Family history
Functional status
Health record component
Interventions (that produce an assessment or measured results)
Laboratory tests
Physical examPatient preference
Risk evaluation
System resources (healthcare resources)
An Example Quality Measure
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An Example Quality MeasureNational Committee for Quality Assurance
Diabetes: Hemoglobin A1c
Poor Control
Percentage of patients 18-75 years of age with diabetes who had
hemoglobin A1c > 9.0% during the measurement period.
Find HbA1c in the EHR with LOINC
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Find HbA1c in the EHR with LOINC
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Many unexpected
successes along the way
photo via heyyu
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Everyone loves LOINC
photo via mccaughan
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The LOINC DistributionLOINC Table, Accessory Files, and Tools and
Resources for Implementers
loinc.org/downloads
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loinc.org/downloads
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LOINC TableThe main LOINC database content
One Record Per Term
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One Record Per Term
Long Common Name Cholesterol in LDL [Mass/volume] in Serumor Plasma b Direct assa
Short Name LDLc SerPl Direct Assay-mCnc
Class Type Lab
Class Chem
Example Units (local) mg/dL
Example Units mg/dL
Order/Obs Both
A Rich Encyclopedia
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A Rich Encyclopedia
Cells.HPV E6+E7 mRNA/cells [Presence] inCervix by Flow cytometry (FC)
Most human papilloma virus (HPV) genomes encode for eight major proteins, six"early" (E1, E2, E3, E4, E6, and E7) and two "late" (L1 and L2). The "early" are regulatory infunction. E6 and E7 genes in high-risk HPV genotypes are known as oncogenes becauseof their continuous expression, which leads to disruption of cell-cycle check points andcell genome instability through alteration of cellular p53 and retinoblastoma proteinfunctions. This test identifies cervical cells containing HPV E6 and E7 polycistronic mRNAusing in situ hybridization with oligonucleotides specific for the mRNA transcripts. The
cells remain intact, and following fixation and permeabilization, the probes enter thecells. The flow cytometer measures two things: 1. Quantification of E6 and E7 mRNA ineach cell and 2. The percentage of cells over-expressing E6 and E7 mRNA.
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LOINC Accessory FilesSpecial representations of LOINC content
Accessory Files
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Accessory Files
LOINC Panels and Forms FileAn export of key panels, survey instruments, and forms in a
detailed data structure.
LOINC Multiaxial Hierarchy FileHierarchical organization of LOINC terms based on their axes.
Lab terms are organized first by Component, then by System.
LOINC Document Ontology FileSpecial file for the detailed naming conventions for clinical
document titles (e.g. Discharge Summary, Progress Note, etc).
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Tools for
Implementers
photo via Robert S Donovan
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loinc.or
g/get-started
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search.loinc.org
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Alternate Language Search
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E t It l !Alternate Language Search
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Everything in Italian!
forum.loinc.org
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loinc.org/usage
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loinc.org/mailing-lists
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No spam! News + release notices
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@LOINC@LOINC
loinc.org/slideshows
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loinc.org/adopters
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loinc.org/adopters
List your organization Free!
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List your organization. Free!
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RELMA®REgenstrief LOINC Mapping Assistant
RELMA Features
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Browse LOINC content
Map local terms to LOINCimport/export
translate local words to LOINC-speak
manual/automated mapping
Search Window
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Mapping Screen
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Mapping Screen
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navigate through your local term set
Mapping Screen
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navigate through your local term set
hit enter to run a search
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22 organizations, 5 countries, 102,000 mappings
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# of codes and institutions mapped to this LOINC
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# of codes and institutions mapped to this LOINC
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Click here to see the local codes!
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When you’ve got a decent number of mappings,share them back with the community
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y
When you’ve got a decent number of mappings,share them back with the community
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y
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LOINC PremiumMembership Programmembers.loinc.org
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Individual Memberships
Donations (Sponsorships)
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Share the love.
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Donate to LOINC.members.loinc.org/donate
members.loinc.org/donate
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What’s still free?
All the Usual Awesomeness
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LOINC Table
Accessory Files
RELMA Program
DocumentationWeb search app (search.loinc.org)
Participation in the LOINC Community
Access to submit new concepts to LOINC
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In closing...
photo via janeandd
Glad you’re here to at least
f
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photo via gmayster01 on & off ...
get your feet wet...
Jump in!
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photo via Justin Ornellas
The Race is On!
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Happy LOINCing!photo via ryarwood
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