LOINC: Origin, development of and perspectives for medical research and biobanking – 20 years on the way to implementation in Germany

Abstract

Twenty-five years of LOINC (Logical Observation Identifier Names and Codes) and almost 20 years of experience with the implementation of LOINC in Germany – without having so far achieved a binding national definition of or a relevant routine use of LOINC in laboratory data communication. This article sketches the development of LOINC use in Germany since the year 2000 on the basis of grey literature. For the first time, the use of LOINC in Germany is experiencing a significant impetus at the national level: On the one hand, the current health legislation with its stipulations for a legally defined electronic patient record provides the necessary framework for nationwide stipulations; on the other hand, there is a significant impulse from the German Medical Informatics Initiative (MII) out of the medical research field for implementing a uniform LOINC subset. In recognition of the 25th anniversary of the LOINC nomenclature (1995–2019), the article traces the emergence of LOINC – which is characterized by interactions between European (EUCLIDES, READ, NPU) and US (HL7, LOINC, SNOMED CT) developments and the interplay of various standardization initiatives. Different national definitions and e-health strategies resulting from this history will be a challenge for the future e-health harmonization in the EU. The concerns of medical research and biobanking must be taken into account here, since the standardization of lab data according to international nomenclatures is of utmost importance for them.

ELaPro, a LOINC-mapped core dataset for top laboratory procedures of eligibility screening for clinical trials

“…1 Schematic representation of the semi-automated method used in this analysis. MDR: Metadata Repository; MDM: Medical Data Models Portal; EC: Eligibility Criteria; UMLS: Unified Medical Language System; MRCONSO: a UMLS table for concept names and sources; MRSTY: a UMLS table for semantic types; SLC: Secondary Laboratory Concept; PLC: Primary Laboratory Concept; LOINC: Logical Observation Identifiers Names and Codes; MII: German Medical Informatics Initiative [ 63 , 64 ]; ODM: Operational Data Model; CSV: Comma-Separated Values …”

LUMA: A Mapping Assistant for Standardizing the Units of LOINC-Coded Laboratory Tests

“…LOINC would be an ideal proxy between the locally used units and UCUM. Firstly, LOINC has garnered widespread usage in the context of clinical and laboratory settings [22], which makes it an ideal foundation to piggyback off. Secondly, it supplies critical information about the proprietary units that can be processed in an automated way, namely in the form of the Scale and Property axis that each LOINC code is associated with.…”

ELaPro, a LOINC-Mapped Core Dataset for Top Laboratory Procedures of Eligibility Screening for Clinical Trials

“…For most LP, a primary and one or more secondary LOINC codes were assigned. The decision of choosing primary and secondary LOINC concepts was based mainly on a well-recognized core dataset created by the Medical Informatics Initiative (MI-I) [72,74] that includes primary and secondary LOINC concepts for the top 300 most common laboratory tests based on data from 5 different university hospitals in Germany. If no proper matching component was found in the MII core dataset for any of our results, the LOINC database V2.7 was directly used to manually assign a primary, and if applicable a secondary LOINC concept(s).…”