The Substance project is considering some changes in this hierarchy, which will affect the mapping of LOINC terms (and have potential effect on the modelling of Observable entities).
The proposed change will be as following: to deprecate the instances of Free X (substance) and replace them with X (substance). E.g 259355006 | Free testosterone (substance) | will be deprecated and replaced by 43688007 | Testosterone (substance) |
The modelling of Testosterone has changed to reflect the change:
January 2018 release:
July 2018 release:
Currently the mapping of the LOINC Parts to SNOMED CT is as following (based on confirmation with RII). The changes in substance hierarchy will have an effect on mapping of the LOINC parts, specifically Testosterone and Testosterone total:
PartNum | Part Type | PartName | Concept ID | FSN | Correlation |
LP18811-7 | COMPONENT | Testosterone.free | 259355006 | Free testosterone (substance) | Exact |
LP29116-8 | COMPONENT | Testosterone.bound | 720374004 | Testosterone bound to sex hormone-binding globulin (SHBG) (substance) | Exact |
LP15881-3 | COMPONENT | Testosterone.free+weakly bound | 710118001 | Bioavailable testosterone (substance) | Exact |
LP19233-3 | COMPONENT | Testosterone.weakly bound | 720355007 | Testosterone bound to albumin (substance) | Exact |
LP14045-6 | COMPONENT | Testosterone | 43688007 | Testosterone (substance) | Snomed CT broader |
LP32165-0 | DIVISORS | Testosterone.total | 43688007 | Testosterone (substance) | Snomed CT broader |
From LOINC website: Testosterone is an androgenic steroid and is the primary male sex hormone. Approximately half of circulating testosterone is tightly bound to a protein called sex hormone binding globulin (SHBG) and is biologically inactive. Another fraction is weakly bound to other proteins, such as albumin, and the remainder is unbound, or "free". Weakly bound and free testosterone together represent bioavailable testosterone. Both total and free testosterone levels decrease with age. Low testosterone is associated with many other conditions, including osteoporosis, Alzheimer’s disease, obesity, diabetes and ischemic heart disease.
We would like to discuss with the group if there are ways to handle the mapping of the total substances using the observable model.