RCMT Mapping Overview Jeremiah Sable Consultant, The St. John Group Contractor to APHL

What problem do the RCMTs solve? Which test results are of public health interest? Lab Test results Consumer of lab data

Filtering the output of clinical labs RCMT tables can identify tests and results of public health interest. RCMT filter Lab Test results Reportable Non reportable Consumer of lab data

Within a public health agency Test results Public health agency TB STD Foodborne Hepatitis etc. RCMT Routing test results within an agency

The problem of non-comparable lab data It isn’t possible to map the test catalog of each lab to reportable conditions. Each lab has its own codes and names for lab tests. There is no consistency across labs. ARUP labs LabCorp Mayo labs etc.... Quest labs

LOINC enables data aggregation across labs It is possible to map LOINC tests to reportable conditions. ARUP labs LabCorp Mayo labs etc.... Quest labs This problem disappears when labs send LOINC codes along with their own codes. LOINC

RCMT mappings for LOINC and SNOMED The RCMT contains mappings of LOINC lab tests and SNOMED organism codes to reportable conditions. The following slides describe the RCMT mappings for two types of LOINC codes: Specific lab tests Nonspecific lab tests

Specific LOINC mappings These four LOINCs are examples of condition-specific tests. Rabies and Giardiasis are reportable conditions and these LOINCs are in the RCMT Aspergillosis and Filariasis are not reportable and these LOINCs are not in the RCMT loinc_numcomponentpropertysystemscalemethodThis is a test for Rabies virus AbACncSerQnNeutRabies Giardia lamblia AgACncStoolOrdEIAGiardiasis Aspergillus fumigatus AgACncTissOrdIFAspergillosis Wuchereria bancrofti AgACncSerQnEIAFilariasis Condition-specific LOINCs

Specific LOINC mappings loinc_numcomponentpropertysystemscalemethodThis is a test for Rabies virus AbACncSerQnNeutRabies Giardia lamblia AgACncStoolOrdEIAGiardiasis Aspergillus fumigatus AgACncTissOrdIFAspergillosis Wuchereria bancrofti AgACncSerQnEIAFilariasis All LOINCs that are specific tests for reportable conditions are in the RCMT. Lab RCMT filter not reportable reportable Condition-specific LOINCs These four LOINCs are examples of condition-specific tests. Rabies and Giardiasis are reportable conditions and these LOINCs are in the RCMT Aspergillosis and Filariasis are not reportable and these LOINCs are not in the RCMT

Specific LOINC mappings Examples of RCMT rows for condition-specific LOINCs loinc_numcomponentsystemscale_typmethod_typCondition name Giardia lamblia AgStoolOrdEIAGiardiasis Giardia lamblia AgStoolOrdIFGiardiasis Giardia lamblia DNAXXXOrdProbe.amp.tarGiardiasis Plasmodium sp DNABldNomProbe.amp.tarMalaria Plasmodium sp AbSerOrdIFMalaria Plasmodium vivax AgBldQnIFMalaria Rabies virus AbCSFQnNeutRabies Rabies virus AgBrainOrdImmune stainRabies Rabies virus RNAXXXOrdProbeRabies Trypanosoma cruzi AbSerOrdEIAChagas disease Trypanosoma cruzi Ab.IgMSerQnEIAChagas disease Trypanosoma cruzi DNABldOrdProbe.amp.tarChagas disease... The RCMT maps these tests to reportable conditions, regardless of the test results The RCMT does not include reporting criteria for condition-specific LOINCs The RCMT has many tests that are not in the case definitions (e.g., Plasmodium sp Ab)

Nonspecific LOINC mappings loinc_numcomponentpropertysystemscalemethodReportable? 600-7Bacteria identifiedPridBldNomCulture? Virus identifiedPridBldNomIF? Ova+Parasites identifiedPridStoolNomConcentration? These nonspecific LOINCs are are too general to be associated with specific conditions. The results of these tests can indicate many different conditions (or no condition) For these LOINCs the RCMT maps the test results (organisms) to reportable conditions This is why the RCMT contains SNOMED organism codes for each reportable conditions Some nonspecific LOINCs

Nonspecific LOINC mappings loinc_numcomponentpropertysystemscalemethodReportable? 600-7Bacteria identifiedPridBldNomCulture? Virus identifiedPridBldNomIF? Ova+Parasites identifiedPridStoolNomConcentration? Some nonspecific LOINCs Lab RCMT filter Nonspecific LOINCs Look at result reportable not reportable These nonspecific LOINCs are are too general to be associated with specific conditions. The results of these tests can indicate many different conditions (or no condition) For these LOINCs the RCMT maps the test results (organisms) to reportable conditions This is why the RCMT contains SNOMED organism codes for each reportable conditions

Nonspecific LOINC mappings RCMT value setLOINCs for... PHVS_LabTestName_BacteriaBacteria nonspecifics PHVS_LabTestName_FungusFungus nonspecifics PHVS_LabTestName_ParasiteParasite nonspecifics PHVS_LabTestName_VirusVirus nonspecifics PHVS_LabTestName_AcidFastStainAcid fast bacillus nonspecifics RCMT value sets of nonspecific LOINCs loinc_numcomponentsystemscalemethodRCMT value setReportable? 600-7Bacteria identifiedBldNomCultureBacterialook at result Bacteria identifiedBldNomAerobic cultureBacterialook at result Ova+Parasites identifiedStoolNomConcentrationParasiteslook at result Ova+Parasites identifiedStoolNomTrichrome stainParasiteslook at result Virus identifiedBldNomIFViruslook at result Virus identifiedCSFNomIFViruslook at result... The RCMT includes more than 400 nonspecific LOINCs

Nonspecific LOINC mappings Examples of RCMT rows for nonspecific LOINCs Concept CodeConcept NameReportable condition Entamoeba histolyticaAmebiasis Entamoeba histolytica cystsAmebiasis Entamoeba histolytica trophozoitesAmebiasis Anaplasma phagocytophilum Anaplasma speciesAnaplasma phagocytophilum Jamestown Canyon virusArbovirus infection Keystone virusArbovirus infection La Crosse virusArbovirus infection West Nile virusArbovirus infection Babesia microtiBabesiosis Babesia divergensBabesiosis... For nonspecific LOINCs the RCMT has SNOMED organism lookup tables for the test results

Summary of RCMT mappings to reportable conditions Lab RCMT filter Nonspecific LOINCs Look at result reportable not reportable Specific LOINCs reportable not reportable This diagram summarizes how the RCMT can be used to filter data coming out of a lab

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