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Laboratory Test Name (Observation Name)Recommendation:LOINC should be used as the standard coding system to identify the test (observation). Alternative 1:The SNOMED CT expression associated with a LOINC code may be used. Alternative 2:SNOMED CT concepts from the 15220000 |Laboratory test| or 363787002 |Observable entity| hierarchy may be used. | ||||||||||||||||||||||||||||||
Laboratory Result Value (Observation Value)Recommendation:Laboratory test results are reported different value types. For example, an LDL cholesterol level may be reported as a numeric value type, the results of a blood culture might identify an organism, and the results of a genetic mutation analysis may be reported as narrative text. In LOINC, these value types are distinguished in the Scale attribute. When a laboratory result observation requires a coded value, SNOMED CT should be used as the standard coding system for such result values. The majority of coded results for reportable laboratory results fall into one of the following SNOMED CT hierarchies:
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Implications of using SNOMED CT for result values
In laboratory test result reporting, the semantic relationship between the identification of the observation and its value is that the asserted value "refines" or "qualifies" the meaning of the laboratory test that is specified in the identification of the observation. In other words, how a particular result should be reported depends upon what is being used as an identification of the observation. This is true regardless of whether SNOMED CT is used.
When SNOMED CT is used for a coded result value, this understanding of the semantic relationship is consistent with the use of refinement as specified in the SNOMED CT Concept Model.
Examples
Example 1: Reportable Condition Mapping Table (RCMT)-Lab Test & Results. CDC Vocabulary Server
The Reportable Condition Mapping Table (RCMT) provides mappings between reportable conditions and their associated LOINC laboratory tests and SNOMED results.
The RCMTs use standards suggested for the meaningful use measure "reportable lab result reporting to public health". They can be used to filter the output of clinical labs for test results that are of interest to public health.
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CDC Vocabulary Server (PHIN VADS). RCMT Tree (Navigator) e.g: Tuberculosis |
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Relationships - Condition and Lab Tests/Results Notifiable Event (Disease/Condition) Code list: Tuberculosis |
Code 1 | Name 1 | Relationship Type | Concept Name 2 | Concept Code 2 | Code System Name 2 |
10220 | Tuberculosis | Associated Lab Test Results | Attenuated Mycobacterium bovis (organism) | 33610009 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium africanum (organism) | 51320008 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium bovis (organism) | 27142009 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium canetti (organism) | 414789006 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium caprae (organism) | 430579009 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium microti (organism) | 70801007 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium pinnipedii (organism) | 430914003 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis (organism) | 113861009 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis African I variant (organism) | 243372002 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis African II variant (organism) | 243373007 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis Asian variant (organism) | 243371009 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis classical variant (organism) | 243370005 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis complex (organism) | 113858008 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Test Results | Mycobacterium tuberculosis hominis (organism) | 36354002 | SNOMED CT |
10220 | Tuberculosis | Associated Lab Tests | Gamma interferon background Bld EIA-aCnc | 71776-9 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | IGNF neg cntrl Bld | 74279-1 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis Ab Ser Ql | 23239-7 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis Ab Ser Ql EIA | 23240-5 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis Ag Bld Ql | 23242-1 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis Ag Tiss Ql ImStn | 23241-3 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis tuberc IGNF Pnl Bld | 53703-5 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis tuberc-control IGNF Bld-aCnc | 53704-3 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M bovis-M avium tuberc IGNF Bld-aCnc | 53702-7 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M tb A60 Ab Ser Ql EIA | 55224-0 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M tb A60 IgM Ser Ql EIA | 55223-2 | LOINC |
10220 | Tuberculosis | Associated Lab Tests | M TB Cmplx DNA XXX Ql PCR | 38379-4 | LOINC |
https://phinvads.cdc.gov/vads/ViewCodeSystemConcept.action?oid=2.16.840.1.114222.4.5.277&code=10220 | |||||
Example 2: CIMI
The Clinical Information Modeling Initiative (CIMI) is an international collaboration dedicated to improving the interoperability of healthcare information systems through shared implementable clinical information models. CIMI's goal is to provide a common format for detailed specifications for the representation of health information content so that semantically interoperable information may be created and shared in health records, messages, and documents. 
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CIMI archetype map for laboratory results report |
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CIMI Modelling Taskforce Report |
Example 3: Value set for Microorganisms/Infectious agents (PHIN-VADS CDC)
Microbiology reporting is a common example of laboratory tests that are reported with coded result values (i.e. the microorganism identified). Use of SNOMED CT to code such results enables reporting and decision support capabilities.
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Value Set Code PHVS_Microorganism_CDC |
Concept Code | Preferred Concept Name | Code System Name |
54857005 | 63U-11 virus | SNOMED CT |
66177001 | 75V-2374 virus | SNOMED CT |
77627007 | 75V-2621 virus | SNOMED CT |
54454006 | 78V-2441 virus | SNOMED CT |
11946001 | Abadina virus | SNOMED CT |
113714003 | Abiotrophia defectiva | SNOMED CT |
409815006 | Abiotrophia para-adiacens | SNOMED CT |
372391001 | Abiotrophia species | SNOMED CT |
17822001 | Abras virus | SNOMED CT |
https://phinvads.cdc.gov/vads/ViewValueSet.action?id=06B09CEF-0E37-E111-A720-0050568D00F8# | ||
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