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Re: [Gnumed-devel] LOINC and decision support

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] LOINC and decision support
Date: Fri, 26 Feb 2010 10:44:01 +0100
User-agent: Mutt/1.5.20 (2009-06-14)

On Thu, Feb 25, 2010 at 11:00:15PM -0800, Jim Busser 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

Yes. This would be done via ICD-x/whatever other appropriate
coding systems we are going to support.

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

GNUmed will identify that by LOINC code. That is exactly why
we have the LOINC code fields on test results.

> - 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.

GNUmed will come with a few pre-defined lists to consider
for which this:

> 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

will help but will also allow the user to edit the list used.

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