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[Gnumed-devel] LOINC and decision support

From: Jim Busser
Subject: [Gnumed-devel] LOINC and decision support
Date: Thu, 25 Feb 2010 23:00:15 -0800

was: Re: French drug database in GNUmed

On 2010-02-25, at 3:13 PM, Jim Busser wrote:

> On 2010-02-15, at 4:05 AM, Karsten Hilbert wrote:
>> I can easily write a GNUmed - FreeDIAMS
>> connector for that.

In order to deliver a proper string to FD, GNUmed should have to query for

- a patient to have a Health Issue that has been coded to a renal failure code 
(despite that GNUmed might contain no quatitative renal function measurement at 
the time of calling FD, the user of GNUmed should perhaps be warned or maybe a 
precaution string could be passed to future FD

- patient's creatinine or creatinine clearance... priority could be to use the 
most recent among the two values

- GNUmed query likely needs to poll for suitable LOINCs. This can be done by 
hand but we may as well be as smart as possible.

There exists a Regenstrief LOINC Mapping Assistant
which is only multi-platform via internet Citrix session at
otherwise runs only on WIndows.
An automated mapping tool was developed to assign LOINC codes. At these sites, 
they were able to map from 63% to 76% of the local active laboratory tests to 
LOINC using the mapping tool. Eleven percent to 27% of the tests were mapped 
manually. They could not assign LOINC codes to 6% to 19% of the laboratory 
tests due to incomplete or incorrect information about these tests.
- the tool itself is unlikely practically available... it was written in MUMPS

For creatinine I also found

and elsewhere

35591-7 Creatinine renal clearance.predicted
35592-5 Creatinine renal clearance/1.73 sq M.predicted
50380-5 Creatinine renal clearance/1.73 sq M.predicted.female
50381-3 Creatinine renal clearance/1.73 sq M.predicted.male
50384-7 Glomerular filtration rate/1.73 sq M.predicted
33914-3 Glomerular filtration rate/1.73 sq M.predicted
48642-3 Glomerular filtration rate/1.73 sq M.predicted.non black
48643-1 Glomerular filtration rate/1.73 sq
50044-7 Glomerular filtration rate/1.73. sq M.predicted.female
50210-4 Glomerular filtration rate/1.73 sq M.predicted

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