Logical observation identifier names and codes (LOINC) - CiteSeerX

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August. 21, 1995; accepted October. 10, 1995. Materials. (ASTM). E1238-94, ... Standard;. I U PAC,. International. Union of Pure and Applied. Chemistry;. flI',. File ..... list of the most common. LOINC kinds of properties is shown in Table. 3. The.
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Chemistry

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code

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Table

10.

LOINC

database

et al.: Logical

Care

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ABXBACT ALLERGY

Antibiotic

RAST/radioimmunoassay Bacteriology Cell counts

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Blood bank Challenge tests

CHALSKIN

Skin

Chemistry

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Coagulation

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Drug concentration

DRUGDOSE

Drug dose

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Fertility

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PROBE

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cerebrospinal

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Virology:

devices

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chemistry

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molar

reporting

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record,

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field

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US).

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concentration

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for

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recommendation

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2), change

3 through

7),

values

list

for

to another

or

for

change

Health

Care,

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nonuse,

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definitional

or partially The

of values

27th in terms

‘T’he 29th

in which

field,

EUCLIDES

the

was

supported

version

Seven,

at the in part

FDA 91-4246. Human

will

of the

Regenstrief

by the

Agency

data

Arbor,

Services,

Center

Health

Public

Health

for Devices

MI:

US Dept. Food

and Radiologic Ghent,

A standard specification and analyte names. and

for medical

MD:

Service,

System Version 4.01. International, 1994.

for Testing

Oxford:

Blackwell

Union of Clinical

laboratory sciences gen: IUPAC, 1990.

Materials,

and

Health,

Belgium:

EU-

for representing Philadelphia, PA:

1995.

Scientific

Publishers,

1995.

of Clinical Chemistry Vol. 1, 1978-1983.

of Pure and Applied Chemistry.

(draft

Chemistry/International

Quantities

and

recommendation).

units

in clinical

Annex

14.

Stevens SS. Measurement, statistics, and the schemapiric Like the faces of Janus, science looks two ways-toward matics and empirics. Science 1968;161:849-56.

15.

American

Medical 4th ed.

World

Health

eases.

Geneva,

Association.

Chicago,

Organization. Switzerland:

value

F. Copenha-

Dybkaer R, Jorgensen K. Measurement Clin Lab Invest 1989;194(Suppl):69-76.

(CPT95), 1994.

recNew

Recommendamethods. Ox-

13.

IUPAC

for

names

International

28th

Institute for

Ann

Rockville,

12.

list

miow being

products.

International Union of Pure and Applied Chemistry. tions for nomenclature in evaluation of analytical ford: Blackwell, 1995.

been

completed

Classification

diagnostic

11.

issues.

or

2.2.

1994.

in vitro

Society

Federation

instead.

field

clinical Philadel-

for electronic

Saris NE, ed. International Federation ommendations and related documents. York: Walter DeGruyter, 1984.

20th

have

to

systems. units.

and

be used

relates

ranges

performed

coding.

10.

16.

was

test

9. International Union of Pure and Applied Chemistry/International Federation of Clinical Chemistry. List of particular properties in clinical laboratory sciences (draft report). Copenhagen: IUPAC/ IFCC, 1994.

whose

reported.

work,

laboratory

protocol

and

sciences.

17. This

on helpful

8. LABMAP. Laboratory Data Code Mapping Utility version 1.4. Ghent, Belgium: EUCLIDES Foundation Intemational, October 1994.

observanon

should

planned

code

units

We

Commission

7. International Union of Pure and Applied Chemistry/International Federation of Clinical Chemistry. The silver book: compendium of terminology and nomenclature of properties in clinical laboratory

to a

a term for

to mnap terms that

21,

26 define

tag

for

links

list example the

indicator

terms

numnher

reference

will

an

necessary

the John

for his very

environments,

Drug Administration, 1991.

comments.

recommnended

to other

will are

(in keeping

reasons

contains

field,

nominal

planned,

of the 1.0/NC’

(fields

22 through

which

most

recent

analyte

19 to the

cross-referencing example

the

whereas

is a list of examnple

field

scope

in

most

or categorical.

that

The

assigned

as ma.ss concentrations

as an addition,

contains

ordinal

demoted

details

change

component field!

The

15th

in the

17th are

he aware

code

defInes

in the

most

National

92196-H).

IUPAC

Chemistry,

about

6. ASTM Standard E-1712. clinical laboratory test

IUPAC

codes

is the the

change

major

terms

practice JUPAC

Ucerc .rhould

The 16th

are defined

concentration

measures.

recent

[7]. Note:

concentrations,

measures

of the

in Clinical

5. EUCLIDES. Coding CLIDES Foundation

and cultures

most

Book

(Grant

An application

and

American

is the

York

Seven.

Level

of Health

blood

Urinalysis

Silver

the 0), and

in healthcare

4. HHS Publication

UA VIRO

field

077 19-013),

3. CEN ENV 1613. Messages for exchange of clinical laboratory information. Brussels: Comit#{233} Europ#{233}en de Normalisation, 1994.

and differential

Toxicology

13th

Chairman

and

exchange

antigens

virus

HS

NO 1 -LM-4-341

of New

Olesen,

Quantities

2. Health

TOX

The

(Grant

(Contract

1. ASTM E1238-94. Standard specification for transferring observations between independent computer systems. phia: American Society for Testing Materials, 1994.

study

TCELL

IFC(:/IUPAC

Research

References

DNA and RNA probes Serology (all antibodies and most bank-related viral antigens) T cell surface models

SERO

and

of Medicine

tests

CHEM CLIN

Clinical

allergen

(blood,

challenge

Policy

A. Hartford

susceptibility

BACT BC

identifier

Library

Ciass

Abbrev.

observation

Current

IL: American International World Health

and scale.

procedural

Medical

Scand

J

view. sche-

terminology

Association,

classification Organization,

of dis1975.

College of American Pathologists. Systematized nomenclature of medicine, international ed. Skokie, IL: College of American Pathologists, 1993.