From PRIME Center (Drs Bhargava and Quine) and Department of Pathology and Laboratory Medicine (Dr Hauser), Veterans Affairs Connecticut Healthcare System, West Haven; and Departments of Public Health (Mr Kim) and Laboratory Medicine (Dr Hauser), Yale University School of Medicine, New Haven, Connecticut.
Arch Pathol Lab Med. 2020 Apr;144(4):478-484. doi: 10.5858/arpa.2019-0055-OA. Epub 2019 Aug 30.
CONTEXT.—: Clinical laboratories are obligated to implement Logical Observation Identifier Names and Codes (LOINC), an informatics standard used to uniquely identify laboratory tests. The historical progress of laboratories in achieving this goal is unknown.
OBJECTIVE.—: To evaluate the implementation of LOINC by clinical laboratories with attention to LOINC's adoption, diversity, and correctness over time.
DESIGN.—: We aggregated data from 130 facilities within the Veterans Health Administration (VA), an early adopter of LOINC, during a 20-year period (1999-2018). To assess the adoption of LOINC, we calculated the annual proportion of tests and results without a LOINC. To assess the diversity of LOINC, we counted the yearly number of distinct LOINCs in active use. To assess the correctness of LOINC over time, we compared the assigned LOINCs to a manually reviewed gold standard for each year.
RESULTS.—: We reviewed a total of 586 000 tests and 9.162 billion results. LOINC adoption, measured as a proportion of both tests and results, improved over time ( < .001). In the final year reviewed, 85% (172 142 of 202 125) of laboratory tests and 99% (547 229 066 of 551 205 087) of results had LOINCs. The number of distinct LOINCs in active use from 1999 to 2018 increased 2.78-fold from 4502 to 12 503 ( < .001). Correctness generally improved but varied considerably by test and across time.
CONCLUSIONS.—: The adoption of LOINC has improved during the past 2 decades. More diverse LOINCs were associated with increased adoption and were a challenge to keep up-to-date. The correctness of LOINCs has improved but remains an issue that likely necessitates supplemental review for most applications.
临床实验室有义务实施逻辑观察标识符名称和代码（LOINC），这是一种用于唯一识别实验室测试的信息学标准。实验室实现这一目标的历史进程尚不清楚。
评估临床实验室对 LOINC 的实施情况，重点关注 LOINC 的采用情况、多样性和随时间的正确性。
我们汇总了退伍军人事务部（VA）内 130 个设施的数据，该部门是 LOINC 的早期采用者，时间跨度为 20 年（1999-2018 年）。为了评估 LOINC 的采用情况，我们计算了每年没有 LOINC 的测试和结果的比例。为了评估 LOINC 的多样性，我们统计了每年使用的不同 LOINC 的数量。为了评估 LOINC 随时间的正确性，我们将每年分配的 LOINC 与手工审查的黄金标准进行了比较。
我们共审查了 586000 次测试和 91.62 亿次结果。LOINC 的采用率（无论是测试还是结果）随着时间的推移都有所提高（<0.001）。在最后一年，85%（202142/202125）的实验室测试和 99%（547229066/551205087）的结果都有 LOINC。1999 年至 2018 年期间，正在使用的不同 LOINC 的数量增加了 2.78 倍，从 4502 个增加到 12503 个（<0.001）。正确性总体上有所提高，但因测试和时间而异。
在过去的 20 年中，LOINC 的采用率有所提高。更多样化的 LOINC 与采用率的提高有关，但也给更新带来了挑战。LOINC 的正确性有所提高，但仍然是大多数应用程序可能需要补充审查的问题。
