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Re: [Gnumed-devel] HL7 OBX result messages that involve multiple lines e


From: James Busser
Subject: Re: [Gnumed-devel] HL7 OBX result messages that involve multiple lines esp Microbiology
Date: Wed, 13 Feb 2008 00:28:09 -0800


On 11-Feb-08, at 4:12 AM, Karsten Hilbert wrote:

OBR|1||02-123456-URC-0^bcb|URC^URINE CULTURE^L||200011081429|
200011081429|||||||200011081429||TTTT2^TEST^BLAIR^^^^^L||||||
200011300944|MICRO|LAB_ORG
|F||^^^200011081429|||||||204
OBX|1|FT|19803-6^SITE^L||Urine|||N|||F|||200011081430|EDM|204
OBX|2|FT|6463-4^Culture^L|1|Light growth of: Klebsiella sp.|||N||| F|||
200011081434
OBX|3|FT|28-1^Ampicillin^L|1|R|||N|||F|||200011081434
OBX|4|FT|149-5^Cephalexin^L|1|R|||N|||F|||200011081434
OBX|5|FT|267-5^Gentamicin^L|1|S|||N|||F|||200011081434
OBX|6|FT|7057-3^TMP/SMX^L|1|S|||N|||F|||200011081434
OBX|7|FT|363-2^Nitrofurantoin^L|1|S|||N|||F|||200011081434
OBX|8|FT|6463-4^Culture^L|2|Light growth of: Staphylococcus aureus|||
N|||F|||200011081434
OBX|9|FT|6932-8^Penicillin^L|2|R|||N|||F|||200011081434
OBX|10|FT|197-4^Cloxacillin^L|2|R|||N|||F|||200011081434
OBX|11|FT|233-7^Erythromycin^L|2|S|||N|||F|||200011081434
OBX|12|FT|7057-3^TMP/SMX^L|2|S|||N|||F|||200011081434
OBX|13|FT|193-3^Clindamycin^L|2|R|||N|||F|||200011081434
OBX|14|FT|524-9^Vancomycin^L|2|R|||N|||F|||200011081434
OBX|15|FT|Ms.OX2^Cloxacillin^L|2|R|||N|||F|||200011081434
OBX|16|FT|28-1^Ampicillin^L|2|S|||N|||F|||200011081434
OBX|17|FT|149-5^Cephalexin^L|2|S|||N|||F|||200011081434
OBX|18|FT|20-8^Amoxicillin/clavulanate^L|2|S|||N|||F|||200011081434

 if I were to write an importer I'd attempt to roll
the above into some tabular format to be put into val_alpha (note that
there can be multiline results in val_alpha).

Note: site == "Urin" ;-))
I'd rather handle this particular case as a test_result of test_type ==
"Urine Culture" with a multiline val_alpha.

Seeing below, it appears that LOINC 19803-6 is used above as "Site" and they have re-interpreted 6463-4 to imply "Culture". The problem is that there is one OBX per antibiotic making none of their LOINCs unique to the test_type, also "Urine culture" has no LOINC so we are back to the problem of the test_code or test_panel and it feels very arbitrary how to reliably get the multiple OBX into one multipline val_alpha unless the observation subid (OBX|1, OBX|2 etc) can reliably be the basis to trigger this.



"LOINC_NUM" "COMPONENT" "PROPERTY" "TIME_ASPCT" "SYSTEM" "SCALE_TYP" "ME THOD_TYP" "RELAT_NMS"
"19803-6"     "Specimen site"       "Type"        "Stdy"        "*"   "Nar"               
  "ENDO.GI"     
"6460-0" "Bacteria identified" "Prid" "Pt" "Sputum" "Nom" "Culture" "MICRO" "6461-8" "Bacteria identified" "Prid" "Pt" "Stool" "Nom" "Anaerobic culture" "MICRO" "6462-6" "Bacteria identified" "Prid" "Pt" "Wound" "Nom" "Culture" "MICRO" "6463-4" "Bacteria identified" "Prid" "Pt" "XXX" "Nom" "Culture" "MICRO"






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