ABSTRACT
The LOINC (Logical Observation Identifier Names and Codes) vocabulary is a set of more than 10,000 names and codes developed for use as observation identifiers in standardized messages exchanged between clinical computer systems. The goal of the study was to create universal names and codes for clinical observations that could be used by all clinical information systems. The LOINC names are structured to facilitate rapid matching, either automated or manual, between local vocabularies and the universal LOINC codes. If LOINC codes are used in clinical messages, each system participating in data exchange needs to match its local vocabulary to the standard vocabulary only once. This will reduce both the time and cost of implementing standardized interfaces. The history of the development of the LOINC vocabulary and the methodology used in its creation are described.
Subject(s)
Clinical Laboratory Information Systems/standards , Vocabulary, Controlled , Classification , Medical Record Linkage/methods , Models, TheoreticalABSTRACT
Many laboratories use electronic message standards to transmit results to their clients. If all laboratories used the same "universal" set of test identifiers, electronic transmission of results would be greatly simplified. The Logical Observation Identifier Names and Codes (LOINC) database aims to be such a code system, covering at least 98% of the average laboratory's tests. The LOINC database should be of interest to hospitals, clinical laboratories, doctors' offices, state health departments, governmental healthcare providers, third-party payors, organizations involved in clinical trials, and quality assurance and utilization reviewers. The fifth release of the LOINC database, containing codes, names, and synonyms for approximately 6300 test observations, is now available on the Internet for public use. Here we describe the LOINC database, the methods used to produce it, and how it may be obtained.
Subject(s)
Clinical Laboratory Information Systems , Diagnostic Tests, Routine , Patient Identification Systems , Clinical Laboratory Information Systems/standards , Clinical Laboratory Information Systems/statistics & numerical data , Computer Communication Networks , Quality Assurance, Health CareABSTRACT
A total of 2766 positive blood cultures, from the Veterans Administration Medical Center in Oklahoma City (1961-1981) were evaluated to determine the relationship of organism, pathogenicity and number of cultures (blood culture bottles) positive. Most patients had 2-4 blood cultures drawn. Organisms which are usually considered as nonpathogenic (Bacillus, Propionibacterium) were mostly found in only one of the cultures. Whereas those microorganisms which are considered pathogenic were most often found in two or more cultures. Organisms like Staphylococcus epidermidis are the most difficult to classify because they can be either pathogenic or contaminant. If an organisms which is normally considered a nonpathogen is found in two or more cultures, it should be considered as a potential pathogen until proven otherwise.
Subject(s)
Bacteria/isolation & purification , Blood/microbiology , Sepsis/diagnosis , HumansABSTRACT
Laboratory data on blood cultures were reviewed for the period 1961-1981. Blood cultures accounted for 18% of all bacterial cultures. Nine percent of all blood cultures were positive for growth, including pathogens and contaminants. Of these, 21% wer contaiminants. Staphylococcus epidermidis was the most common contaminant while Escherichia coli and Staphylococcus aureus were the most frequently occurring pathogens, respectively. Four percent of all positive blood cultures, involving pathogens, had multiple organisms with E. coli the most common. There was no drastic change in the frequency of occurrence of Gram negative or positive isolates over the years, but certain pathogens like Proteus mirabilis, Serratia sp. and Group A Streptococci were more common from 1971-81 than 1961-70. One percent of all patients with positive blood cultures had the same organism for two months or longer. Analysis of these longer occurring infections yielded a mean of 15, median of 7 and range of 2-87 months. E. coli was the most common pathogen in these chronic infections, followed by S. aureus and Streptococcus pneumoniae, respectively.
Subject(s)
Cross Infection/epidemiology , Sepsis/epidemiology , Adult , Hospital Bed Capacity, 300 to 499 , Humans , Male , OklahomaABSTRACT
Laboratory data, on positive blood cultures, were reviewed for the period 1961-1981. A total of 1809 episodes of bacteremia and fungemia were evaluated as to monthly occurrence. Of these, 42% were due to Gram positive cocci, 51% to Gram negative bacilli, 5% to anaerobes and 2% to yeasts. When seasonal patterns were categorized, most were bi- or multiphasic except Streptococcus pneumoniae and Staphylococcus aureus which yielded mono- and aphasic patterns, respectively. These results show the occurrence of certain pathogens, like S. pneumoniae, to be linked with seasons or months of the year.
