Enabling international adoption of LOINC through translation

Interoperable health information exchange depends on adoption of terminology standards, but international use of such standards can be challenging because of language differences between local concept names and the standard terminology. To address this important barrier, we describe the evolution of an efficient process for constructing translations of LOINC terms names, the foreign language functions in RELMA, and the current state of translations in LOINC. We also present the development of the Italian translation to illustrate how translation is enabling adoption in international contexts. We built a tool that finds the unique list of LOINC Parts that make up a given set of LOINC terms. This list enables translation of smaller pieces like the core component "hepatitis c virus" separately from all the suffixes that could appear with it, such "Ab.IgG", "DNA", and "RNA". We built another tool that generates a translation of a full LOINC name from all of these atomic pieces. As of version 2.36 (June 2011), LOINC terms have been translated into nine languages from 15 linguistic variants other than its native English. The five largest linguistic variants have all used the Part-based translation mechanism. However, even with efficient tools and processes, translation of standard terminology is a complex undertaking. Two of the prominent linguistic challenges that translators have faced include: the approach to handling acronyms and abbreviations, and the differences in linguistic syntax (e.g. word order) between languages. LOINC's open and customizable approach has enabled many different groups to create translations that met their needs and matched their resources. Distributing the standard and its many language translations at no cost worldwide accelerates LOINC adoption globally, and is an important enabler of interoperable health information exchange.

[1]  Daniel J. Vreeman,et al.  Automated Mapping of Local Radiology Terms to LOINC , 2005, AMIA.

[2]  S M Huff,et al.  A Characterization of Local LOINC Mapping for Laboratory Tests in Three Large Institutions , 2010, Methods of Information in Medicine.

[3]  Daniel J. Vreeman,et al.  Embracing Change in a Health Information Exchange , 2008, AMIA.

[4]  Nicolette de Keizer,et al.  The role of standardized data and terminological systems in computerized clinical decision support systems: Literature review and survey , 2011, Int. J. Medical Informatics.

[5]  Daniel J. Vreeman,et al.  A Rationale for Parsimonious Laboratory Term Mapping by Frequency , 2007, AMIA.

[6]  Peter D. Stetson,et al.  Case Report: Iterative Evaluation of the Health Level 7 - Logical Observation Identifiers Names and Codes Clinical Document Ontology for Representing Clinical Document Names: A Case Report , 2009, J. Am. Medical Informatics Assoc..

[7]  Lee Min Lau,et al.  Mapping Department of Defense Laboratory Results to Logical Observation Identifiers Names and Codes (LOINC®) , 2005, AMIA.

[8]  Daniel J. Vreeman,et al.  Logical Observation Identifiers Names and Codes (LOINC®) users' guide , 2010 .

[9]  James J. Cimino,et al.  Combining laboratory data sets from multiple institutions using the logical observation identifier names and codes (LOINC) , 1998, Int. J. Medical Informatics.

[10]  C. McDonald,et al.  LOINC, a universal standard for identifying laboratory observations: a 5-year update. , 2003, Clinical chemistry.

[11]  C. McDonald,et al.  Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic reporting of clinical laboratory test results. , 1996, Clinical chemistry.

[12]  Daniel J. Vreeman,et al.  A Comparison of Intelligent Mapper and Document Similarity Scores for Mapping Local Radiology Terms to LOINC , 2006, AMIA.

[13]  Sylvia Thun,et al.  Case Report: LOINC® Codes for Hospital Information Systems Documents: A Case Study , 2009, J. Am. Medical Informatics Assoc..

[14]  Daniel R. Luna,et al.  Development of the Spanish version of the Systematized Nomenclature of Medicine: methodology and main issues , 2000, AMIA.

[15]  J. Cimino Desiderata for Controlled Medical Vocabularies in the Twenty-First Century , 1998, Methods of Information in Medicine.

[16]  Clement J. McDonald,et al.  Viewpoint: The Barriers to Electronic Medical Record Systems and How to Overcome Them , 1997, J. Am. Medical Informatics Assoc..

[17]  Stéfan Jacques Darmoni,et al.  Assisting the Translation of SNOMED CT into French using UMLS and four Representative French-language Terminologies , 2009, AMIA.

[18]  Olivier Bodenreider,et al.  The caBIG terminology review process , 2009, J. Biomed. Informatics.