Stream: terminology
Topic: Loinc Question
Grahame Grieve (Mar 01 2018 at 03:01):
I'm working on observation codes for the vietnamese national record. They've got a paper template that I have to show how to represent in FHIR. Here's a question:
Grahame Grieve (Mar 01 2018 at 03:03):
Personal health risk factors:
Tobacco use: □ No □ Yes □ Often □ Stopped
Grahame Grieve (Mar 01 2018 at 03:04):
If I look in LOINC, I see a number of smoking status codes, all specific to a particular context of use, with recommended answer lists. The definitions and answer lists don't match.. but there's no generic 'smoking status for smokers and non smokers'.
Grahame Grieve (Mar 01 2018 at 03:06):
I guess the nearest code is 72166-2.. but this has a normative answer list which has unclear mappings.... and the definition seems CDC specific.
Grahame Grieve (Mar 01 2018 at 03:06):
Should I use a LOINC code... @Rob Hausam @Daniel Vreeman @Stan Huff thoughts?
Alejandro Metke (Mar 01 2018 at 03:20):
I have mapped similar things in the past using SCT. You could use:
code = 365981007 | Tobacco smoking behaviour - finding
value = 8392000 | Non-smoker
= 77176002 | Smoker
= 230063004 | Heavy cigarette smoker
= 160617001 | Stopped smoking
Grahame Grieve (Mar 01 2018 at 03:25):
hah I can't use SCT here!
Alejandro Metke (Mar 01 2018 at 03:32):
Of course... vietnamese national record
Grahame Grieve (Mar 01 2018 at 03:37):
Then there's this: "Toilet type in family (flush toilet / two-compartment latrine / no toilet):" - nothing remotely like that in LOINC... I guess it's a developing world thing...
Rob Hausam (Mar 01 2018 at 03:40):
LOINC 63638-1 is similar to 72166-2, and I think either could potentially be used - but both of them have specific methods, which I don't like. I would want to be more inclined to something like 81229-7, which doesn't have a specific method - but it, unfortunately, is specifically "for tobacco smoker". Probably 72166-2 is the best of these - and you're not bound by the answer list (even normative) or the Class/Type (where that is an issue, not here), and probably you can overlook the method. But it's sounding like a new LOINC code probably would be best.
Grahame Grieve (Mar 01 2018 at 03:45):
what does a normative answer list mean if it's not normative?
Rob Hausam (Mar 01 2018 at 03:52):
ok, I was wrong about that - lists that are declared as normative actually are required to be used that way :)
I was confusing the rules on that with some of the other aspects, like Class/Type, which appear to be definitional, but aren't
Grahame Grieve (Mar 01 2018 at 03:53):
OK. Inconvenient to my case, but sensible
Michael Lawley (Mar 01 2018 at 04:38):
Custom CodeSystem with a ConceptMap to the SCT codes? The map wouldn't be valid to use in Vietnam without an affiliate licence, but would serve to anchor the meanings. You'd be defining the ConceptMap and therefore you'd be the one using SNOMED, which you have a licence for.
Grahame Grieve (Mar 01 2018 at 05:34):
interesting. could vietnam publish that map?
Lloyd McKenzie (Mar 01 2018 at 05:48):
And how aligned can a custom code system with a direct SNOMED CT mapping be before it would be considered to be impinging on SNOMED's IP?
Grahame Grieve (Mar 01 2018 at 05:49):
I was assuming that it would be 100% SNOMED CT IP. But since I'm not using SNOMED CT in production, nor is Vietnam, we can just go ahead and publish it, right?
Rob Hausam (Mar 01 2018 at 05:57):
Not sure about that - but it might be something worth finding out.
Grahame Grieve (Mar 01 2018 at 05:58):
it's the sort of thing that sounds wrong but sometimes isn't because of the way the rules are written
Grahame Grieve (Mar 01 2018 at 05:59):
but I think the Vietnamese government probably wouldn't want to take that path anyway
Michael Lawley (Mar 01 2018 at 08:35):
I don’t think there’d be any IP issue with the code system because it’s come straight from the paper form
Michael Lawley (Mar 01 2018 at 08:35):
If A snomed licensee publishes the map, then they’re okay. The grey area is in the use of the map.
Michael Lawley (Mar 01 2018 at 08:36):
Note, this would be pretty clearly out of bounds for LOINC as it’s licence is actively hostile to maps, but I see no problem for snomed (IANAL)
Grahame Grieve (Mar 01 2018 at 08:53):
but then why would I bother with snomed?
Michael Lawley (Mar 02 2018 at 04:26):
It would anchor the meaning for those people who are licensed. This may not help anyone, but there may be vendors operating in Vietnam who have affiliate licences for SNOMED and it would by helpful for them.
Robert McClure (Mar 02 2018 at 23:56):
@Grahame Grieve and @Michael Lawley This is a question that you must run through the HTA. As member of the HTA, it is my understanding that any entity that wants to use a map that is a derivative of SCT must have a snomed ct license. SNOMED says they will work with any requester to come to a reasonable license.
Michael Lawley (Mar 03 2018 at 00:00):
That’s what I was getting at. It is the use of the map that requires an appropriate licence.
Grahame Grieve (Mar 04 2018 at 18:28):
but why should HTA have jurisdiction over this question - does HTA claim jurisdiction over an affiliate countries use of SCT?
Robert McClure (Mar 05 2018 at 03:44):
HTA has jurisdiction over questions of the use of external code systems in HL7 standards.
Michael Lawley (Mar 05 2018 at 03:49):
I thought this was use in a Vietnamese local context?
Grahame Grieve (Mar 05 2018 at 04:05):
yes, not an HL7 standard. Though affiliates would be an in interesting position if HTA asserts authority over their joint work with the national authorities
Last updated: Apr 12 2022 at 19:14 UTC
