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THIS PAGE WAS USED FOR DISCUSSION OF RANGES AND CARDINALITIES AND HAS NOW BEEN FED BACK TO THE OBSERVABLES INCEPTION AND ELABORATION DOCUMENT

Attribute

Description

Example of value

Card-inality

Range (including descendants)

704318007 | Property type |

This attribute is used to specify the type of inherent quality or process that is to be observed. Its values are abstract types of quality (length, odor, concentration) or abstract types of process features (rate, speed), and do not include qualities that are located (length of arm, odor of urine), or given a value (elevated concentration).

Length, Mass, Concentration, Relative concentration, Ability, Susceptibility, Rate

0..1

<< 118598001 | Property of measurement |

704319004 | Inheres in |

This attribute specifies the independent continuant which bears the quality, and on which the dependent quality (of this observable) depends.

Mass of the body: mass is the property which inheres in the entire body.

 

Anything that is the bearer of a property

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

718497002 | Inherent location |

This attribute specifies the location of the entity specified by the attribute 704319004 | Inheres in |.

Serotype of bacteria in blood: serotype is the property type, which inheres in the bacteria which is (happens to be) located (inherent location) in blood.

Diameter of papule of the skin of the nose: diameter/length is the property type, which inheres in the papule which is located (inherent location) in the skin of the nose. Here, the diameter is the diameter of the papule, not the skin of the nose.

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

704320005 | Towards (attribute) |

This needs to be updated, the text definition in SNOMED CT is old and wrong!

For dispositions, this attribute specifies what the disposition is towards.

The susceptibility towards antimicrobial agents of a (population) of microorganisms

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

704326004 | Precondition (attribute) |

This attribute is used to specify body state, timing, challenges, and other situations that is true of the entity at the time of observation.

For standing blood pressure, the precondition is the fact that the subject is in standing position (state) during observation

0..*

<< 404684003 |Clinical finding| OR << 703763000 |Precondition value| OR << 71388002 |Procedure|

246093002 | Component (attribute) |

For relational property types, e.g. ratios, concentrations, etc., this attributed specifies what is in the numerator of the ratio.

From IUPAC Gold Book: “Constituent of a mixture the amount or concentration of which can be varied independently.”

For sodium ion concentration in plasma, sodium ion is the component

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

704325000 | Relative to (attribute) |

This attribute is used to specify the numerator of a relative relational property type, such as a ratio of ratios.

See section 6.3.1.2

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

719715003 | Relative to part of (attribute) |

This attribute is used to specify the denominator of a relative relational property type, such as a ratio of ratios.

See section 6.3.1.2

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

704321009 | Characterizes (attribute) |

This attribute specifies the process which is characterized by the observed feature.

Secretion

0..*

<< 719982003 |Process|

704322002 | Process agent (attribute) |

This attribute is used to specify a participant (such as a body structure or organism) that is causally active in the process on characterized by the observed feature.

Thyroid gland, Kidney, Pace maker

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product|

704323007 | Process duration (attribute) |

This attribute specifies the duration of the process characterized by the observed feature.

For 24 hour urine cortisol excretion rate, 24 hours is the process duration

0..1

<< 7389001 | Time frame (qualifier value) |

704324001 | Process output (attribute) |

This attribute specifies the resulting output of the process characterized by the observed feature.

For 24 hour urine cortisol excretion rate, cortisol is the process output. For heart rate, a cardiac cycle is the process output.

0..*

<< 105590001 |Substance| OR << 719982003 |Process|

719722006 | Has realization (attribute) |

This attribute specifies the realization of a function

For Ability to walk, walking is what is realized.

0..*

<< 719982003 |Process|

246501002 | Technique (attribute) |

This attribute is used to specify the systematic method of a procedure used to accomplish a specific activity.

Automated count, manual count, for number concentrations

Pulse oximetry, for heart/pulse rate

0..*

<< 272394005 | Technique (qualifier value) |

704327008 | Direct site (attribute) |

This attribute represents the specific entity on which the observation is directly made, and is used when the observation is indirect, such as when a direct observation is not possible to be done on the entity in which the observable inheres.

Sublingual space as a oral measurement proxy of core body temperature.

Serum specimen, for measurement of serum concentrations.

0..*

<< 123037004 |Body structure| OR << 410607006 |Organism| OR << 105590001 |Substance| OR << 123038009 |Specimen| OR << 260787004 |Physical object| OR << 373873005 |Pharmaceutical / biologic product| OR << 419891008 |Record artifact|

370132008 | Scale type (attribute) |

This attribute refers to the scale of the result of an observation or a diagnostic test.

Nominal, ordinal, quantitative.

0..1

<< 30766002 |Quantitative| OR << 26716007 |Qualitative| OR << 117363000 |Ordinal value| OR << 117365007 |Ordinal or quantitative value| OR << 117362005 |Nominal value| OR << 117364006 |Narrative value| OR << 117444000 |Text value|

246514001 | Units (attribute) |

This attribute represents the units used in assigning a value to an observation.

Meter, mmHg

0..1

<< 258666001 | Unit (qualifier value) |

424226004 | Using device (attribute) |

This attribute refers to the instrument or equipment utilised to execute an action. | USING DEVICE | is used when the device is actually used to carry out the action that is the focus of the procedure.

Mercury manual sphygmomanometer, Goniometer

0..*

<< 49062001 | Device (physical object) |

363701004 | Direct substance (attribute) |

[From Procedure model] This attribute describes the | Substance | or | Pharmaceutical / biologic product | on which the procedure's method directly acts.

The procedure here refers to the observation procedure.

Protein as a proxy for genetic variant0..*<< 105590001 |Substance (substance)| OR << 373873005 |Pharmaceutical / biologic product (product)|
370134009 | Time aspect (attribute) |

This attribute specifies temporal relationships for a measurement procedure.

LOINC-mapping example0..1

<< 7389001 | Time frame (qualifier value) |

     
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16 Comments

  1. James R. Campbell

    Daniel

    I notice that 363701004|Direct substance(attribute) is not in the inventory...I assume an oversight?

    Jim

    1. Daniel Karlsson

      That was proposed to meet your needs for MP modeling consistency between different methods. I'd be happy to add that now that it has proved its worth in the model. This should be confirmed at the next Observables PG meeting.

  2. Daniel Karlsson

    Where is time aspect...

    1. Suzanne Santamaria

      Daniel, I think it was an oversight that time aspect was not added. It should be included.

  3. James R. Campbell

    Comparing to the instance of MRCM we have deployed, we have:

    Direct site with values body structure, specimen, organism, substance, physical object, pharmaceutical product and record artifact

    We have Clinical finding and NOT Specimen in the  valueset for TOWARDS

     

    We thought we added 1400001000004103|Specimen preparation technique(attribute)| as non-defining at the London meeting

    SNOMED concept id for 704325000|relative to(attribute)| is listed twice in the model with one wrong SNCTID

    HAS REALIZATION is not in SNOMED CT 

    1. Daniel Karlsson

      The use of TOWARDS changed from Aug '15, this is the current range. Do you still use TOWARDS for the AP/MP observables? I thought not. My recollection of the specimen preparation technique was that that would be part of the definition of the specimen and not the observable. Thanks, Daniel

  4. Suzanne Santamaria

    Hi Jim,

    Just a note that 719722006 | Has realization (attribute) | was added in the January 2017 International Release.

    Also, I don't see 704325000 | Relative to (attribute)| listed twice in the table above. I see one 704325000 | Relative to(attribute)|  and one 123456789 | Relative to part of (attribute) |.

    Thanks,

    Suzanne

    1. Daniel Karlsson

      Hi, I added Time aspect and the definition from the editorial guide. I think we need to add guidance on how to use Time aspect in relation to Process duration. Do you have an example from the LOINC mapping work? Also corrected the SCTID of Rel.to part of. Thanks, Daniel

      1. Suzanne Santamaria

        Hi Daniel,

        For an example, do you mean something like "123029007 | Single point in time (qualifier value)." 

        Suzanne

        1. Daniel Karlsson

          Something like this:

          "For aggregate quality observables, e.g. maximum over 24 hours, the attribute | Time aspec | is used to specify the timing of aggregation. The value 123029007 | Sinlge point in time | is used for non-aggregated observables.

          For process observables, the attribute | Process duration | is used to specify the duration of the process specified by the | Characterizes | attribute."

          However, I'm not sure this distinction is sufficient to describe the use of the two attributes, e.g. collection of urine in the bladder is a kind of aggregation process.

          What do others think?

          /Daniel

          1. Suzanne Santamaria

            Daniel,

            Some excerpts of text to be included in the LOINC - SNOMED CT Cooperation Project Beta release documentation regarding modeling timing is as below. Is this in line with what you are suggesting? If not, we need to discuss this as soon as possible as there is very limited time to make any adjustments to the Beta release at this point.

              • LOINC Time to SNOMED CT attributes

                • LOINC Time Part Pt → Time aspect attribute = Single point in time in SNOMED CT

                • LOINC Time of X hrs = Process duration attribute in SNOMED CT

                  • Exception: Where LOINC System = urine AND Time = X hours AND Property is not one of MRat, SRat, VRat, and NRat, the Term is mapped as such:

                    • Specimen = Change map from Urine → X hour urine sample

                    • Time = Change map from X hrs → Single point in time

                    • Inheres in is not affected

            • Some LOINC Component Parts (generally substances) are mapped using the Component and/or Process output attribute in SNOMED CT depending on the time aspect and property of a LOINC Term. When the Property type is MRat, SRat, VRat, and NRat, and Time = 24 hrs, then the Process output attribute carries the SNOMED CT concept equivalent to the LOINC Component. Otherwise, the Component attribute carries the SNOMED CT concept equivalent to the LOINC Component. A LOINC Term will generally only include a value for Component OR for Process Output, but not both. The Part map may include a value for Component and Process Output.

              • Example: Creatinine is used as a value of the Component attribute in LOINC Term Creatinine/Calcium [Mass Ratio] in Urine. Creatinine is used as a value of the Process output attribute in LOINC Term Creatinine [Mass/volume] in 24 hour Urine.

            • The LOINC Terms in this Beta Release are modeled as either quality observables or process observables. See an example of a quality observable expression in the first row in the table and a process observable in the second row of the table.

             

            id

            mapTarget

            expression

            correlationId

            b14bd80e-d892-4902-a18e-3039223460f3

            5574-9 | Aluminum:MCnc:Pt:Ser/Plas:Qn

            363787002|Observable entity|:704318007|Property Type|=118539007|Mass concentration|,370134009|Time aspect|=123029007|Single point in time|,704327008|Direct Site|=122592007|Acellular blood (serum or plasma) specimen|,246093002|Component|=12503006|Aluminum|,370132008|Scale|=30766002|Quantitative|,704319004|Inheres In|=50863008|Plasma|

            447557004 | Exact match map from SNOMED CT source code to target code (foundation metadata concept)

            69617976-aad4-4baa-bcfe-2455daa7b0f7

            15047-4 | Creatine:SRat:24H:Urine:Qn

            363787002|Observable entity|:704323007|Process Duration|=123027009|24 hours|,704321009|Characterizes|=718500008|Excretory process|,704322002|Process Agent|=64033007|Kidney|,704324001|Process Output|=14804005|Creatine|,370132008|Scale|=30766002|Quantitative|,704318007|Property Type|=118562009|Substance rate|,704327008|Direct Site|=278020009|Spot urine sample|

            447557004 | Exact match map from SNOMED CT source code to target code (foundation metadata concept

             

             

            1. Daniel Karlsson

              Hi Suzanne,

              are there examples for quality observables with | time aspect | different from | single point in time | ? Cf. 314462001 | Average 24 hour diastolic blood pressure (observable entity) |

              /Daniel

              1. Suzanne Santamaria

                Hi Daniel,

                We don't have any examples of those in the LOINC Beta release files, but we do have some in the modeled vital sign observables as you noted.

                Cheers,

                Suzanne

            2. Suzanne Santamaria

              Daniel,

              When discussing this, we need to also consider James R. Campbell's question about why Inheres in is not currently included in modeling the 24 hour urine samples. His question was here. 

              Thanks,

              Suzanne

               

  5. Michael Osborne

    Can we just add a reference to the observables style guide, same as for relative-to and relative-to-part-of ? This is a very flat table and doesn't lend itself to co-ordinate between attributes.

    1. Daniel Karlsson

      Michael Osborne, this table was copied from the style guide and will be copied back once everything is sufficiently sorted out.